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    Admitting Notes

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    joy bajarias

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    © All Rights Reserved
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    Admitting Notes

    Uploaded by

    joy bajarias
    2 views1 page

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    2 views1 page

    Admitting Notes

    Uploaded by

    joy bajarias

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    BARILI BIRTHING CENTER

    POBLACION, BARILI, CEBU, PHILIPPINES 6036

    ADMITTING NOTES

    __________________________________________________________________________________________________

    Last Name Middle Name First Name Age Status

    __________________________________________________________________________________________________

    Address # of Admission Date/Time of Admission

    Chief Complaint:

    __________________________________________________________________________________________________
    __________________________________________________________________________________________________

    History of Present Illness:

    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________

    Medical Surgical Risk Factors:

    Hypertension ( ) Thyroid Disorder ( ) Epilepsy ( ) History of previous C/S ( )

    Heart Disease ( ) Obesity ( ) Renal Disease ( ) History of Uterine Rupture/Atony ( )

    Diabetes ( ) Mod. To Severe Asthma ( ) Bleeding Disorder ( ) Myomectomy ` ( )

    OB HISTORY: Menarche: _____________


    OB Score: G_____ P_____ ( T _____ P _____ A _____ L _____ )
    LMP: ____________________________
    EDC: ____________________________
    AOG: ____________________________
    Prenatal Check up : _____________________________________________________________________
    _____________________________________________________________________________________

    GRAVIDA PLACE OF YEAR HANDLED TYPE OF SEX/CONDITION WEIGHT COMPLICATIONS


    DELIVERY BY DELIVERY

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