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FDAR
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FDAR
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Percentage Score: __________
Student’s Name: _________________________ Year, Section & Group #: ____________________________________
Concept: ________________________________ Clinical Instructor: ____________________________________
Date: Shift: Ward: NOD:
NURSES NOTES
[_____________________________][___________________][_______][_______][________][_____________________]
LAST NAME GIVEN NAME M.I. AGE SEX ROOM NO. HOSPITAL NO.
Attending Physician_______________________________ Diagnosis______________________________________
DATE/TIME F (FOCUS) D (DATA) - A (ACTION) - R (RESPONSE)
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