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Medical Record No:
In Time
Case type
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SHIFT
A
B
C
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Followup to(if Applicable)
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Referred By
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INJURY DEFINE
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Initiated
Not Initiated
Injury Time
Complaints
Complaints
OHC Staff Notes
On Examination Findings
Injury
Type
Part
Classification
Procedure
Medicine
Dosage
For Days
Qty
Price Per Unit
Stock
Issued
Total Price
Total Amount :
Medicine Disbursment
Yes
No
Referral
Follow-up
Emergency?
No
Yes
Chargeable?
No
Yes
Weight
Height
BMI
SBP
DBP
Temperature
Respiratory Rate
Heart Rate
Urine output
FBS
RBS
PPBS
SPO2
AVPU
TRAMA
oxygen supplementation
glasgow coma scale
Mobility
Affected Body Parts
Health Advices
Recommended Tests For Checkup
Additional Precautions