Republic of the Philippines
Department of Health
UNIVERSITY OF THE CORDILLERAS HOSPITAL
logo Baguio City
Form No.:
MONITORING SHEET Revision No.:
Effectivity Date:
WEIGHT:________________
DATE/ O2 ADDITIONAL PARAMETERS AS ORDERED
BP CR RR TEMP. URINE STOOL
TIME SAT.
11-30-2021
10:00 am 100/60 85 18 36.6 98 2 1
2:00 pm 110/75 80 17 36.2 99 3 1
Name of Patient: ____Benilda mae Tandoc___________ Hospital No.:_________