Generic Template

PRE-OPERATIVE

Operation: 
Indication:
Date:
CEPOD:
Surgeon:
Assistant:
Anaesthetist:
Anaesthetic:
ASA Grade:
WHO Checklist:
Antibiotics:
Urinary Catheter:
Patient Position:

INTRA-OP

Ports:

Findings:

Procedure:

Closure:

POST OPERATIVE INSTRUCTIONS

Observations Q4H
Post op bloods tomorrow (ddmmyy)
Diet: Eat and Drink as tolerated
LMWH at 18:00 hours