7/25/2019 Medicine Template

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PROBLEM LIST

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5

MEDS

PMHx/PSurgHx:

SHx:

FamHx:

Home Meds:

ALL:

ROS:

PMD/Consults:

ROOM:

ID:CC:

DOA:

PE Notes:

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SUBJECTIVE:

Overnight:

Pain:

Ambulation:Diet/PO:Voiding:

Cardio/Pulm:

Abd:

Incision:

Extremities:

Physical Exam

7/25/2019 Medicine Template

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LABS

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TO DO

CaMgPh

Tm HR BP R O2sat I/O

P L M E B

Tm HR BP R O2sat I/O

Tm HR BP R O2sat I/O

Tm HR BP R O2sat I/O

Tm HR BP R O2sat I/O

Tm HR BP R O2sat I/O

Tm HR BP R O2sat I/O

CaMgPh

CaMgPh

CaMgPh

CaMgPh

CaMgPh

CaMgPh

P L M E B

P L M E B

P L M E B

P L M E B

P L M E B

P L M E B

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PO:IV:

T:

Urine:

NG:Stool:Drains:

T:

PO:IV:

T:

Urine:NG:Stool:Drains:

T:

PO:IV:

T:

Urine:

NG:Stool:Drains:

T:

PO:IV:

T:

Urine:

NG:Stool:Drains:

T:

PO:IV:

T:

Urine:

NG:

Stool:

Drains:

T: