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    OR Case File

    Uploaded by

    Leziel L. Empiales
    Sample template

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    OR Case File

    Uploaded by

    Leziel L. Empiales
    5 views2 pages
    Sample template

    Original Title

    OR-Case-File

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Sample template

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    5 views2 pages

    OR Case File

    Uploaded by

    Leziel L. Empiales
    Sample template

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    OPERATING ROOM _________________ CASES

    Name : Date of Operation :


    Age : Time Started :
    Status : OR Institution :
    Religion : Case Number :

    Pre – op Diagnosis:

    Operation Performed:

    Post – op Diagnosis:

    Surgeon :
    Assistant Surgeon :
    Anesthesiologist :
    Type of Anesthesia : Anesthetic Agent :

    Pack (Drape) Used :

    Instruments (Set) Used :

    Skin Preparation :
    Organ(s) Involved :

    Organ(s)/Tissue Layer(s) Involved:

    Organ(s)/Layer(s) Suture(s) Needle(s)

    Student Scrub Nurse Student Circulating


    Nurse

    Clinical Instructor

    Circulating Nurse/Nurse On Duty

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