Form for Boys' Camp Nurse
 


Date:            
 
Camper's First Name:       Camper's Last Name: 

Camper's Cabin: 
Has the camper already gone to the doctor?       
                  If yes, what was the doctor's diagnosis? 
                 
                  If no, is camper going to doctor today?  
 
How long do you expect the camper in the Nurses' Station?     
 
Camper is taking medication   times a day.
 
Camper has the following restrictions:
 

 
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