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Indoor Treatment Sheet

This indoor treatment sheet contains clinical information for a patient, including temperature, pulse, respiratory rate, blood pressure, fluid intake and output, progress notes, medication reconciliation, general orders from nurses, verbal orders, and the doctor's signature. It provides a record of the patient's condition and care on a given date and time following a surgery or chemotherapy treatment.

Uploaded by

Hiral Panchal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
2K views2 pages

Indoor Treatment Sheet

This indoor treatment sheet contains clinical information for a patient, including temperature, pulse, respiratory rate, blood pressure, fluid intake and output, progress notes, medication reconciliation, general orders from nurses, verbal orders, and the doctor's signature. It provides a record of the patient's condition and care on a given date and time following a surgery or chemotherapy treatment.

Uploaded by

Hiral Panchal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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S T I C K E R

Indoor Treatment Sheet


Date: Time:
Date of Surgery: Post Operative Day: Diet:

Clinical Notes
Temp: Pulse: /Min. R.R: min. .B.P. / mm of Hg
Input: ml. Output: ml D.O.:
Progress Notes/Advice:

Medication Reconciliation:

General Orders Time / Sign of Nurse

Verbal Order

Name & Sign of Doctor:


Indoor Treatment Sheet
Date: Time:
Date of Surgery: Post Operative Day: Chemo Day: Diet:

Clinical Notes
Temp: Pulse: /Min. R.R: min. .B.P. / mm of Hg
Input: ml. Output: ml D.O.:
Progress Notes/Advice:

Medication Reconciliation:

General Orders Time / Sign of Nurse

Verbal Order

Name & Sign of Doctor:

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