Medication Log Sheet
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1P3080-2.2
1
MEDICATION
LOG SHEET
Date: ___________________
Name of Student:
_________________________________________ Date of Birth: __/ __/ __
Allergies:
_______________________________________________________________________
Medication:
_______________________________________________ Dosage: ________________
Time of Administration:
____________________________________________________________
Date
Time
Dose
Given By
Date
Time
Dose
Given By
1
Medication means prescription medication and over-the-counter medication.
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Parent category: Medical