Patient Encounter Log

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PATIENT ENCOUNTER LOG
Supervising Physician: _______________
Name/Date: _____________________
Patient Name
MR #
CC
Acty
Procedures
Lvl of Care
Primary Dx
Sec Dx
Dispo
Comments/FU
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Type: North__ South __ Peds __
Hrs:
___ AM/PM until ___ AM/PM

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