A Sample MAR

 

PATIENT NAME
ROOM/BED AGE WEIGHT
BSA
SEX
Regional Memorial Hospital
Doe, John
242-2
58
111kg
-
M
Somewhere, FL
MEDICAL RECORD #
PATIENT ACCT #
DOCTOR NAME
DOSE PERIOD
1348764
2254897
N. Example, MD
9/3/2000
DIAGNOSIS
ALLERGIES
MEDICATION ADMINISTRATION TIMES
Chest Pain / Angina
NKA
TIME / SITE / INITIAL | TIME / SITE / INITIAL | TIME / SITE / INITIAL
Lanoxin 0.25mg PO qD
0900
-
CP
-
-
-
-
-
-
Nitropaste 2% 1/2" chest wall q8°
0600
-
CP
1400
-
DS
2200
-
LM
EC ASA 81mg PO qD
0900
-
CP
-
-
-
-
-
-
Captopril 25mg PO TID
0600
-
CP
1400
-
DS
2200
-
LM
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
MOM 30ml qD prn
-
-
-
-
-
-
-
-
-
APAP 500mg 2 PO q6° prn HA
-
-
-
1830
-
DS
-
-
-
PATIENT NAME
ROOM / BED
NOTES
Doe, John
242-2
-