NURSING CARE PLAN

Name of Patient ________________________________________________

Age __________ Sex ___________ Civil Status ______________________ Nationality_________________________ Occupation _________________________

Date of Admission _____________________________Chief Complaint / Diagnosis _________________________________________________________________

Brief History

Scientific Scientific
CUES Nursing Diagnosis Nursing Objective Nursing Intervention Evaluation
Explanation Explanation

Name of Student ____________________________________________ Rating _________________________________

Year / Section _________________________ ________________________________________

Clinical Instructor

667 F.T. Dalupan Sr. St., Sampaloc, Manila Philippines

www.marychilescollge.edu.ph / marychilescollege@gmail.com
Tel. 711 - 4233, 735-5341 to 45
 Print Name & Signature

667 F.T. Dalupan Sr. St., Sampaloc, Manila Philippines

www.marychilescollge.edu.ph / marychilescollege@gmail.com
Tel. 711 - 4233, 735-5341 to 45