Patient Identification
Past Medical History
Medication & Allergy
Pre-operative Assessment
Relevant Laboratory Investigations
| Investigation |
Date |
Result |
| Hb | | |
| WBC | | |
| Platelet | | |
| Creatinine | | |
| Electrolytes | | |
| Coagulation Profile | | |
| ECG | | |
| Chest X-Ray | | |
| Others | | |
Consent & Preparation
Comments/Plan