OR Schedule Reschedule Form

Jack Doe (1234567890)

Male - 64 year - B +ve

Dr. John Doe Surgery (NS OPD 2)

Apt. ID - 372439

Admit ID - 405588

Patient Billing Code

GEN

Payment Priority

Note Alert

Luis Hall

PID 562588

Dr. Sateesh Talpade

Lorem id natoque in elementum velit. Lorem facilisi sit id est, cras commodo. Id dignissim at elit cras mattis nulla lacus quam.

15 min ago

High Valid for this visit only

Dr. Sateesh Talpade

Lorem id natoque in elementum velit. Lorem facilisi sit id est, cras commodo.

15 min ago

Medium Valid for this visit only

Dr. Sateesh Talpade

Morbi est nisl at integer potenti tincidunt. Eget vel ac quis arcu lacus cras dui, a enim. Nam lectus arcu, ultrices egestas malesuada tempor luctus. Commodo lectus dui pellentesque dictumst. Est in tincidunt etiam.

07-07-2022, 10:10 AM

Low From 07-07-2022 to 14-07-2022

Operation Room Request

Pre - OP Surgery Name

Ordered By

Dr. Sateesh Talpade

Department

Medicine

Order#

1234567890

OR Name

Surgeon

Dr. Sateesh Talpade

Co.Surgeon

Anesthesiologist

Anes Type

Other Anes Type

Severity Status

Emergency

Diagnosis

Cystic Fibrosis Diaphragmatic Hernia Omphalocele

Approx. Duration for surgery

Hrs :

Min.

Preferred Date & Time

25-03-2019, 11:30

Scheduled Date & Time

NPO

Procedure Type

In-Patient

Admission Date & Time

23-03-2019, 10:30

Back

Online Uploading (75%)

24-08-2019, 10:10 AM