ARRANGEMENT OF FILE FOR MEDICAL PATIENT (PEDIA/ADULT) - HARDCOPY

I. PATIENT INFORMATION SUMMARY FORM

1. ADMISSION – DISCHARGE FORM
2. COPY OF IDENTIFICATION CARD (IQAMA/ PASSPORT)
II. REFUSAL OF CARE AGAINST MEDICAL ADVICE
III. DNR ORDER
IV. INTERNAL AND EXTERNAL TRANSFER FORM
1. AMBULANCE FLOW SHEET – IF THERE IS ORDER/REQUEST TO TRANSFER TO OTHER FACILITIY OR HOSPITAL
FOR FURTHER MANAGEMENT
V. GENERAL CONSENT FOR ADMISSION
VI. INFORMED CONSENT FOR SURGERY / PROCEDURE
VII. INTENSIVE CARE UNIT (ICU) FLOWCHART – IF PATIENT IS ADMITTED OR TRANSFRRED TO ICU
VIII. MODIFIED EARLY WARNINGS SIGNS FOR ADULT – IF ADULT PATIENT NEEDS RRT
IX. PEDIATRIC EARLY WARNINGS SIGNS – IF PEDIATRIC PATIENT NEEDS RRT
X. CODE BLUE FORM (PATIENT’S COPY) – IF HAD CODE BLUE
XI. NARCOTIC PRESCRIPTION PAD (PATIENT’S COPY)

ARRANGEMENT OF FILE FOR SURGICAL PATIENT (PEDIA/ADULT) – HARDCOPY

I. PATIENT INFORMATION SUMMARY FORM

1. ADMISSION – DISCHARGE FORM
2. COPY OF IDENTIFICATION CARD (IQAMA/ PASSPORT)
II. REFUSAL OF CARE AGAINST MEDICAL ADVICE
III. DNR ORDER
IV. INTERNAL AND EXTERNAL TRANSFER FORM
1. AMBULANCE FLOW SHEET – IF THERE IS ORDER/REQUEST TO TRANSFER TO OTHER FACILITIY OR HOSPITAL
FOR FURTHER MANAGEMENT
V. GENERAL CONSENT FOR ADMISSION
VI. INFORMED CONSENT FOR SURGERY / PROCEDURE
VII. HIGH RISK CONSENT FOR SURGERY/PROCEDURE
VIII. ANESTHESIA INFORMED CONSENT
IX. INTENSIVE CARE UNIT (ICU) FLOWCHART – IF PATIENT IS TRANSFERRED TO ICU
X. MODIFIED EARLY WARNING SIGNS FOR ADULT – IF ADULT PATIENT NEEDS RRT
XI. PEDIATRIC EARLY WARNING SIGNS – IF PEDIATRIC PATIENT NEEDS RRT
XII. CODE BLUE FORM (PATIENT’S COPY) – IF PATIENT HAD COBE BLUE
XIII. NARCOTIC PRESCRIPTION PAD (PATIENT’S COPY)
ARRANGEMENT OF FILE FOR OB – GYNE (MATERNITY) PATIENT - HARDCOPY

I. PATIENT INFORMATION SUMMARY FORM

1. ADMISSION – DISCHARGE FORM
2. COPY OF IDENTIFICATION CARD (IQAMA/ PASSPORT)
II. REFUSAL OF CARE AGAINST MEDICAL ADVICE
III. DNR ORDER
IV. GENERAL CONSENT FOR ADMISSION
V. INFORMED CONSENT FOR SURGERY / PROCEDURE
VI. HIGH RISK CONSENT FOR SURGERY / PROCEDURE
VII. ANESTHESIA INFORMED CONSENT
VIII. PARTOGRAPH FORM
IX. PARTOGRAPH RESULTS
X. MODIFIED OBSTETRIC WARNING SIGNS – IF PATIENT NEEDS RRT
XI. CODE BLUE FORM (PATIENT’S COPY) – IF PATIENT HAD CODE BLUE
XII. NARCOTIC PRESCRIPTION PAD (PATIENT’S COPY)

ARRANGEMENT OF FILE FOR OPD PATIENT – HARDCOPY

I. CONSENT FOR OUTPATIENT FORM

II. GENERAL CONSENT FOR ADMISSION
III. INFORMED CONSENT FOR SURGERY / PROCEDURE
IV. HIGH RISK CONSENT FOR SURGERY / PROCEDURE
V. ANESTHESIA INFORMED CONSENT
VI. CLINICAL NOTES – FOR DR. HASSAN NASSER’S PATIENT
VII. INTERNATIONAL GROWTH CHART FOR HEIGHT, WEIGHT, AND HEAD CIRCUMFERENCE ACCORDING TO AGE AND
SEX
VIII. GROWTH CHART FOR SAUDI CHILDREN FOR HEIGHT, WEIGHT, AND HEAD CIRCUMFERENCE ACCORDING TO AGE
AND SEX

ARRANGEMENT OF FILE FOR ER PATIENT – HARDCOPY

I. PATIENT INFORMATION SUMMARY FORM

1. ADMISSION – DISCHARGE FORM
2. COPY OF IDENTIFICATION CARD (IQAMA/PASSPORT)
II. REFUSAL OF CARE AGAINST MEDICAL ADVICE
III. DNR ORDER
IV. INTERNAL AND EXTERNAL TRANSFER FORM
1. AMBULANCE FLOW SHEET – IF THERE IS ORDER/REQUEST TO TRANSFER TO OTHER FACILITIY OR HOSPITAL
FOR FURTHER MANAGEMENT
V. GENERAL CONSENT FOR ADMISSION
VI. INFORMED CONSENT FOR SURGERY / PROCEDURE
VII. HIGH RISK CONSENT FOR SURGERY / PROCEDURE
VIII. ANESTHESIA INFORMED CONSENT
IX. MODIFIED OBSTETRIC WARNING SIGNS – IF PATIENT NEEDS RRT
X. CODE BLUE FORM (PATIENT’S COPY) – IF PATIENT HAD CODE BLUE
XI. NARCOTIC PRESCRIPTION PAD (PATIENT’S COPY)
ARRANGEMENT OF FILE FOR NICU AND NURSERY PATIENT – HARDCOPY

I. BIRTH NOTIFICATION
XII. GENERAL CONSENT FOR ADMISSION
XIII. INFORMED CONSENT FOR SURGERY / PROCEDURE
XIV. HIGH RISK CONSENT FOR SURGERY / PROCEDURE
XV. ANESTHESIA INFORMED CONSENT