ePhysician

Describe the main theme of the questions.

Last Name

First Name

Middle Name

Gender

Date of Birth

Age

Attending Physician

HEALTH CARE PROVIDER'S NOTES
_S_ubjective,_O_jective,_A_{ssessment and}_P_{lan of Care}

ORDERS

Date / Time:

Expected Length of Stay in days (LOS):

Review of Current Medication:

Prepared By:

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Monitor and Record Vital Signs every hours:

Patient's Diet:

Activate Clinical Pathway

Diagnostic Tests with Clinical Indication

Blood & Microscopic Examinations

Imaging Studies

Other Diagnostics

Refer to:

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