PATIENT DISCHARGE INSTRUCTIONS
Health Record Number:
PATIENT’S NAME: Tabudlo Zack ___
(Surname) (First) (Middle)
Age: 1 year old Sex: Male Status: Child Ward: COVID WING PIW Bed Number:
Address: Cotabato City Date: 04/23/21
Date Admitted: 04/19/21 Date Discharged: 04/23/21
Final Diagnosis: Acute Gastroenteritis with Moderate Dehydration
I. SCHEDULE OF MEDICINES
Before
Noon
Morning Evening Bedtime Midnight
MEDICINES (Maudto
(Mapita) (Magabi) (Bago (Lukigay)
)
Matulog)
1. Zinc sulfate drops, 2ml OD for 1 6am
week
2. Baclofen 10mg/tab ½ tab TID p.o for 6am 12nn 6pm
5 days
3. Carbamazepine 100mg/5ml syrup 2.5 6am 6pm
ml BID p.o for 3 days
4. Valproic acid 250mg/5ml 1.4 ml BID 6am 6pm
for 7 days
5.
6.
7.
8.
9.
10.
II. DIET INSTRUCTIONS: __________BF with SAP___________________________________
III. PRESCRIBED: ________________________________________________________________
EXERCISES: ____________________________________________________________________
IV. YOUR NEXT APPOINTMENT WILL BE ON: 2 weeks after discharge
Prepared by: Noted by:
Chua, Marielle P./Pegarro, KG.
NDU BSN 2 NDU CI
T 04/23/2021 3:30PM j n Dr. Macaayan, MD h
Nurse on Duty Resident-in-Charge