Post-Surgical Discharge Summary
Patient Information
Full Name
Date of Birth
Medical Record Number
Hospital Details
Hospital Name
Date of Admission
Date of Discharge
Surgery Details
Procedure Name
Date of Surgery
Surgeon
Indication for Surgery
Intraoperative Findings
Hospital Course
Summary of Postoperative Course
Discharge Medications
Follow-Up Instructions
Next Appointment
Special Instructions
Contact Information
Contact for Questions