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Neonatal Jaundice - Nursing Assessment on Admission

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Header / Title

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Referring Unit/Hospital

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Baby's Sex

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Place Of Birth

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Date And Time Of Birth

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Home Address

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Date And Time Of Admission

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FAMILY INFORMATION

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Mother's Name

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Father's Name

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Father's Work Place

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Address

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Others

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VITAL SIGNS

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MANAGEMENT AND NURSING CARE

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SIGNATURES

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