Form for Girls' 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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