ADOLESCENT LOGBOOK (10-19 yrs old)

MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES

VISIT RENDERED
FEBRUARY

MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES

VISIT RENDERED
MARCH 12/M -Consultation -Tetanus toxoid
Dx: Punctured given
Wound, sole of -Meds given
the foot, right -Advised
16/M -Consultation -Tetanus toxoid
Dx: Punctured given
Wound, 2nd digit -Meds given
of the finger, right -Advised
 12/M Lymphadenitis, -Meds given
groin area, left -Advised

MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES

VISIT RENDERED
APRIL 12/M Consultation -Tetanus toxoid
Punctured given
Wound, sole of -Meds given
the foot, right
 MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES
VISIT RENDERED
MAY Calimpon, Jethro 17/M BS II -Consultation -Meds given
Dx: Acute -Advised for
Gastritis possible
admission
 MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES
VISIT RENDERED
JUNE Maruhom, 17/F -Consultation -Advised
Hamina -Dx: Essentially
Well Adolescent
Obena, Rogelio 17/M -Consultation -Wound suturing
Dx: Lacerated done
Wound, leg, left -TT given
-Meds given
-Advised

MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES

VISIT RENDERED
JULY Apat, Fenijay 18/M Dableston -Consultation -TT given
Dx: Punctured -Meds given
Wound, popliteal -Advised
area, right
 Sayson, Joshua 19/M Bauyan -Consultation
Dx: Schizophrenia
Udile, Tobias 16/F Dableston -Consultation
Dx:
Hypersensitivity
Reaction

MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES

VISIT RENDERED
AUGUST 12/M Consultation -Tetanus toxoid
Punctured given
Wound, sole of -Meds given
the foot, right
 MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES
VISIT RENDERED
SEPTEMBER 12/M Consultation -Tetanus toxoid
Punctured given
Wound, sole of -Meds given
the foot, right
 MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES
VISIT RENDERED
OCTOBER 12/M Consultation -Tetanus toxoid
Punctured given
Wound, sole of -Meds given
the foot, right

MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES

VISIT RENDERED
NOVEMBER 12/M Consultation -Tetanus toxoid
Punctured given
 Wound, sole of -Meds given
the foot, right

MONTH NAME BIRTHDATE AGE/SEX ADDRESS PURPOSE OF SERVICES

VISIT RENDERED
DECEMBER1 12/M Consultation -Tetanus toxoid
Punctured given
Wound, sole of -Meds given
the foot, right