Patients Name:___________________________
Civil Status:_____________
Religion:___________________
Date of Discharge:________________________
Address:_________________________________
Admission No.:__________
Physician:__________________
Diagnosis:_______________________________
Date&Time Admitted:______________________
Age:______
Ward:_____________________
_______________________________________
Sex:______
Nursing Care Plan
CUES
NURSING DIAGNOSIS
OBJECTIVES
_________________________________
Clinical Instructor
NURSING INTERVENTIONS
RATIONALE
________________________________
Bsn2/Group2
EVALUATION