Rm:
Name:
Age/Sex:
Admit:
MD:
Diet:
Act:
Allergy:
Code:
F
DNR
Safe:
Fall
Seiz
Iso:
C
D
A
BG:
Q1
Q4
Q6
Dx:
PMH:
SYSTEMS
Neuro:
CV:
Resp:
GI/GU:
Skin:
Pain:
VITALS
T
HR
BP
RR
O₂
P
LABS
WBC
Hgb
Plt
Na
K
Glu
BUN
Cr
Mg
PT
INR
Trop
IN
OUT
LINES
NOTES
Rm:
Name:
Age/Sex:
Admit:
MD:
Diet:
Act:
Allergy:
Code:
F
DNR
Safe:
Fall
Seiz
Iso:
C
D
A
BG:
Q1
Q4
Q6
Dx:
PMH:
SYSTEMS
Neuro:
CV:
Resp:
GI/GU:
Skin:
Pain:
VITALS
T
HR
BP
RR
O₂
P
LABS
WBC
Hgb
Plt
Na
K
Glu
BUN
Cr
Mg
PT
INR
Trop
IN
OUT
LINES
NOTES
Rm:
Name:
Age/Sex:
Admit:
MD:
Diet:
Act:
Allergy:
Code:
F
DNR
Safe:
Fall
Seiz
Iso:
C
D
A
BG:
Q1
Q4
Q6
Dx:
PMH:
SYSTEMS
Neuro:
CV:
Resp:
GI/GU:
Skin:
Pain:
VITALS
T
HR
BP
RR
O₂
P
LABS
WBC
Hgb
Plt
Na
K
Glu
BUN
Cr
Mg
PT
INR
Trop
IN
OUT
LINES
NOTES
Rm:
Name:
Age/Sex:
Admit:
MD:
Diet:
Act:
Allergy:
Code:
F
DNR
Safe:
Fall
Seiz
Iso:
C
D
A
BG:
Q1
Q4
Q6
Dx:
PMH:
SYSTEMS
Neuro:
CV:
Resp:
GI/GU:
Skin:
Pain:
VITALS
T
HR
BP
RR
O₂
P
LABS
WBC
Hgb
Plt
Na
K
Glu
BUN
Cr
Mg
PT
INR
Trop
IN
OUT
LINES
NOTES