CARING NURSES, INC.
ROC Verbal Orders for Modification or Revision of Plan of Care Post Hospitalization
Patient Chart
Patient: ITKIS, YURI - 900007106
Chart: 4 Episode: 1
Form Date: 09/11/2024
2968 E. RUSSELL ROAD
LAS VEGAS, NV 89120
Phone: 702-791-3729
Fax: 702-791-3859
Patient PHONE#:
ADDRESS: City: State: Zip Code:
Physician Name:


ADDITIONAL OR NEW DIAGNOSIS FOR HHC:

SURGICAL TREATMENT AND DATE

NEW ORDERS/MEDICATIONS





CURRENT CERTIFICATION PERIOD: FROM 07/31/2024 TO 09/28/2024
Physician Signature: Date:



Status:
Pending