This document contains a student medication sheet with fields to record a patient's allergies, up to six medications including their generic name, trade name, dosage, ordered dose, administration route, time to give, and notes. The sheet is used to track a patient's medications and ensure they are administered correctly.

1. STUDENT MED SHEET * * * Pt. allergies:
Date: Initials/Room #:
Drug/Dosage Classification Pt on it for:
Gen:
Trade:
Dosage:
ORDERED DOSE:
Time to give: NOTES:
Route: by mouth Tab Cap Inhaler
Liq Suspn Liquid Drink
IV IVPB IVPush
IM SC ID
Other:
Drug/Dosage Classification Pt on it for:
Gen:
Trade:
Dosage:
ORDERED DOSE:
Time to give: NOTES:
Route: by mouth Tab Cap Inhaler
Liq Suspn Liquid Drink
IV IVPB IVPush
IM SC ID
Other:
Drug/Dosage Classification Pt on it for:
Gen:
Trade:
Dosage:
ORDERED DOSE:
Time to give: NOTES:
Route: by mouth Tab Cap Inhaler
Liq Suspn Liquid Drink
IV IVPB IVPush
IM SC ID
Other:
Drug/Dosage Classification Pt on it for:
Gen:
Trade:
Dosage:
ORDERED DOSE:
Time to give: NOTES:
Route: by mouth Tab Cap Inhaler
Liq Suspn Liquid Drink
IV IVPB IVPush
IM SC ID
Other:
Drug/Dosage Classification Pt on it for:
Gen:
Trade:
Dosage:
ORDERED DOSE:
Time to give: NOTES:
Route: by mouth Tab Cap Inhaler
Liq Suspn Liquid Drink
IV IVPB IVPush
IM SC ID
Other: