| Admission Consent: | Present |
| Blood Transfusion Consent: | Not Applicable |
| Cost Consent: | Not Applicable |
| Procedure Consent: | Not Applicable |
| High Risk Consent: | Not Applicable |
| Anesthesia Consent: | Present |
| LAMA/DOR Consent: | Not Applicable |
| Discharge Consent: | Not Applicable |
| Pharmacy Replacement: | |
| Billing Completed : | |
| Discharge summary explained and handed over : | |
| Prescription explained and handed over : | |
| Report handed over : | |
| Iv Cannula Removed : | |
| Hospital Dress Changed : | |
| Hospital belonging checked and taken back : | |
| Pending report informed: | |
| Attending Nursing Staff: | Arpita Singh |