Naimat Child Care Clinic
Patient Name
S/o. D/o.
Date of Birth (Optional)
Age (Y - M - D)
Weight (e.g. 2.600)
Hospital No
Report Date
Generate & Print Report
NAIMAT CHILD CARE CLINIC
Bhutta Chowk Khanewal 065-2555111
Name:
S/o. D/o.:
Weight:
Age:
Date:
Hosp No:
TIME
TEMP
RECP RATE
HEART RATE
FLUID OUTPUT
FLUID INTAKE
REMARKS
VOMITUS
URINE
STOOL
TYPE(ORAL)
VOL
TYPE(I/V)
VOL
TOTAL
