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    Capitol University College of Nursing Cagayan de Oro City OPERATING ROOM CASES Case Number:_______________ RECORD Date of Operation:________________ Name of Patient:___________ Age:________ Sex:_______ Civil Status:________ Ward / Room:________ Bed No.:________ Name of Hospital:____________________________ Type of Anesthesia:______________................_____________________ Anesthesiologist:____________________________________ Time Anesthesia Began:

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    Or and Dr Cases Record New

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    Capitol University College of Nursing Cagayan de Oro City OPERATING ROOM CASES Case Number:_______________ RECORD Date of Operation:________________ Name of Patient:___________ Age:________ Sex:_______ Civil Status:________ Ward / Room:________ Bed No.:________ Name of Hospital:____________________________ Type of Anesthesia:______________................_____________________ Anesthesiologist:____________________________________ Time Anesthesia Began:

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    165 views2 pages

    Or and DR Cases Record New

    Uploaded by

    api-3739910
    Capitol University College of Nursing Cagayan de Oro City OPERATING ROOM CASES Case Number:_______________ RECORD Date of Operation:________________ Name of Patient:___________ Age:________ Sex:_______ Civil Status:________ Ward / Room:________ Bed No.:________ Name of Hospital:____________________________ Type of Anesthesia:______________................_____________________ Anesthesiologist:____________________________________ Time Anesthesia Began:

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    Capitol University CU-QMS-NURSING-0014

    College of Nursing
    Cagayan de Oro City

    OPERATING ROOM CASES RECORD

    Case Number:_______________ Date of Operation:_________________

    Name of Patient:_________________________________ Age:__________ Sex:_______


    Civil Status:_______________ Ward/Room:_______________ Bed No.:_________
    Name of Hospital:_______________________________________________________

    Pre-Operative Diagnosis:

    Operation Performed:

    ( ) Major Operation ( ) Minor Operation ( ) Circulating

    Post-Operative Diagnosis:

    Name of Surgeon:_________________________________
    1st Asst:____________________________________
    2nd Asst:____________________________________

    Type of Anesthesia:________________________________
    Anesthesiologist:___________________________________

    Time Anesthesia Began:______________ Time Anesthesia Ended:____________

    Time Operation Started:______________ Time Operation Ended:_____________

    Name & Signature of Student:__________________________________

    _____________________________ _____________________________
    _____________________________ _____________________________
    Name & Signature of OR Scrub Nurse Name & Signature of OR Circulating Nurse

    _____________________________ _____________________________
    Name & Signature of OR Clinical Instructor Name & Signature of OR Supervisor
    Issue: 05April 2006 Revision Code :003
    Capitol University CU-QMS-NURSING-0015
    College of Nursing
    Cagayan de Oro City

    DELIVERY ROOM CASES RECORD

    Case Number:_______________ Date of Delivery:_________________


    Time of Delivery:_________________

    Name of Patient:_________________________________ Age:__________ Sex:_______


    Civil Status:_______________ Ward/Room:_______________ Bed No.:_________
    Name of Hospital:_______________________________________________________

    Type of Delivery:__________________________________________
    __________________________________________

    Diagnosis:

    GTPAL Scoring:____________________________

    Name of Baby:_______________________________ Gender of Baby:_____________

    Attending Physician:________________________________________

    ( ) Handle
    ( ) Assist
    ( ) Cord Dressing

    _____________________________ _____________________________
    Name & Signature of Student Name & Signature of DR Nurse-On-Duty

    _____________________________ _____________________________
    Name & Signature of DR Clinical Instructor Name & Signature of DR Supervisor

    Issue: 05April 2006 Revision Code :003

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