Nursing 24 Hours Fluid Balance Chart
Doctor
Surgery
Ward / Room / Bed No.
Intake
Output
Date
Time
Intravenous
Amount
Oral
Amount
Gastricsuction
Urine
Vomitus
Stool
Remarks
By User
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
14 July 2006
22:35
oral
20,000
xxxx
xxxxxxx
None
None
None
None
None
Nurse
