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