Republic of the Philippines
Department of Health
                                            UNIVERSITY OF THE CORDILLERAS HOSPITAL
        logo                                               Baguio City
                                                                        Form No.:
                            MONITORING SHEET                            Revision No.:
                                                                        Effectivity Date:
WEIGHT:________________
   DATE/                                     O2                       ADDITIONAL PARAMETERS AS ORDERED
                BP     CR     RR   TEMP.             URINE STOOL
    TIME                                    SAT.
 11-30-2021
 10:00 am      100/60 85     18    36.6    98        2     1
 2:00 pm       110/75 80     17    36.2    99        3     1
Name of Patient: ____Benilda mae Tandoc___________                       Hospital No.:_________