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Healthcare Quality Management Student Workbook - 5 edition Project 3-3: Create a Cycle Time Data Collection Tool Project Desc
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Patient details registration form:

Patient Registration Form
S. 7No Details To be filled by patient Remarks if any
1 Patient Name
2 Address
3 Contact number
4 Age
5 Sex
6 Diagnosis
7 When diagnosed
8 Any other illness
9 Doctor to be consulted
10 When started from home
11 what time reached hospital
12 Waiting time at reception
13 Appointment time
14 Vitals sign check start & end time
15 Doctor consultation start & end time
16 Start & end time with nurse
17 Start & end time with Nutritionist
18 Start & end time with Respiratory Therapy
19 Start & end time with Social worker
20 Time at which patient leave the clinic
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