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ANIL D THOMAS |
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ADMIN11 |
Doctor |
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Admission Order
| Please Admit on |
10/03/2012 |
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At |
11:57:54 AM |
| Dept. |
ANASTHESIOLOGY |
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Unit |
ANASTHESIA |
| Signature of Admitting Dr |
Aadhil |
Discharge Order
| Dept. |
ANASTHESIOLOGY |
|
Unit |
ANASTHESIA |
| Signature of Discharging Dr |
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NURSES
For Admitting office only
| Admitted under Dr |
Aadhil |
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Dept |
ANASTHESIOLOGY |
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Unit |
ANASTHESIA |
| Date of Admission |
10/03/2012 |
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IP No |
0000208747 |
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Time |
11:57:54 AM |
| Allocated Room / Bed |
1032 |
| Name & Signature of admitting officer |
Aadhil |
| (CAPITTAL LETTER) DOCTORS (Fill within 24Hrs of discharge) |
International Code |
| Provisional Diagnosis |
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Final Diagnosis
(Main & Additional ) |
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| Discharge Status |
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If expierd cause of death |
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| Name & Signature of Doctor Aadhil |
Date 10/03/2012 |
Name & Signature of Unit Head |
Date |
Medical Records Department
| No. of sheets in the Record |
Sorting & Assembling By |
Deficiency Check By |
Coding By |
Addmission & Dicharge Record