Scribd
Upload
48 views3 pages

Patient Discharge Summary Template

The discharge summary provides essential patient details including name, age, sex, and hospital identification. It outlines the patient's final diagnosis, history on admission, treatment history, and condition at discharge, along with medication and dietary advice. Follow-up instructions and emergency contact information are also included for continued care.

Uploaded by

raiganj local
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
48 views3 pages

Patient Discharge Summary Template

The discharge summary provides essential patient details including name, age, sex, and hospital identification. It outlines the patient's final diagnosis, history on admission, treatment history, and condition at discharge, along with medication and dietary advice. Follow-up instructions and emergency contact information are also included for continued care.

Uploaded by

raiganj local
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

DISCHARGE SUMMARY

PATIENT DETAILS

PATIENT NAME: __________________________________________________________ AGE: SEX: M / F

UHID : WARD: GEN DELUX CABIN ICU HDU BED:

CONSULTANT: ____________________________________ DOA: ___________________ DOD: ___________________

FINAL DIAGNOSIS

HISTORY ON ADMISSION

PRESENTING COMPLAINTS:

PAST MEDICAL/ SURGICAL/ FAMILY/ OTHER HISTORY:

HISTORY OF DRUG ALLERGY:

CLINICAL FINDINGS ON ADMISSION

TREATMENT / PROCEDURE HISTORY


INVESTIGATIONS PERFORMED

CONDITION OF THE PATIENT AT THE TIME OF DISCHARGE

MEDICATION ADVICE ON DISCHARGE

SL DRUG NAME DOSAGE ROUTE


.
N MEAL MEAL

O.
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15

DIET AND OTHER ADVICE


DISCHARGE DISPOSITION (tick the appropriate option)

HOME DORB
REFERRED TO HIGHER CENTRE LAMA

FOLLOW UP

FOLLOW UP DATE IN OPD :

FOLLOW UP INVESTIGATION ADVICE :

OTHER INSTRUCTIONS

IN CASE YOU CONTINUE TO BE SICK DESPITE MEDICATION WITH NO RELIEF OF


SIGN AND SYMPTOMS OR FEELING VERY UNWELL AND NEW SYMPTOMS
DEVELOP OR IN CASE OF ANY MEDICAL EMERGENCY PLEASE CONTACT JEEVAN

REKHA HOSPITAL EMERGENCY AT +918373066644 /

+918373066655 AND ATTEND EMERGENCY DEPARTMENT IMMEDIATELY


OR ANY OTHER NEARBY HOSPITAL.

Signature of Consultant Signature of Duty Doctor

Name: Name:

Registration No: Registration No:

Date & Time: Date & Time:

You might also like