Proforma for data collection cancer effected patients: Patient/Case ID.NO: _______________ PROFORMA FOR DATA COLLECTION CLINICAL PHARMACY PATIENTS MEDICATION PROFILE PROJECT: Demographic data: s-no Patients data Detail 1 Name 2 Bed number 3 Registration number 4 Age/ date of birth 5 Gender 6 Marital status 7 Location Chemo ward 8 Date of admission 9 Cycle no 10 Height cm 11 Weight kgs 12 Body surface area m2 13 Contact number ...
Science knowledge: Include both 1)Biological science knowledge. 2)Abiological science knowledge. General knowledge: Include 1) Art. 2) Fashion. 3) Politics. 4) Sport. 5) International affairs. 6) National affairs. 7) History. 8) Literature.