C-Section Post-Surgical Follow-Up Record
Patient Information
Name
Date of Birth
Medical Record Number
Surgery Details
Surgery Date
Surgeon
Hospital
Follow-Up Assessment
Follow-Up Date
Days Post-Surgery
Vitals (BP, Temp, Pulse)
Pain Level
Mild
Moderate
Severe
Mobility
Wound Appearance
Lochia
Urine Output
Bowel Movements
Breastfeeding Status
Other Symptoms/Findings
Plan / Recommendations
Provider Signature
Provider Name
Date