Neonatal Jaundice Monitoring System
Patient Information
Mother's Name:
IC Number:
Time of Birth:
Mother's Blood Group:
Select
A+
A-
B+
B-
AB+
AB-
O+
O-
Period of Gestation:
+
weeks
Birth Weight (kg):
Baby's Blood Group:
Select / Unknown
A+
A-
B+
B-
AB+
AB-
O+
O-
DAT/Coombs Test:
Select / Unknown
Positive
Negative
Pending
Risk Factors (check all that apply):
ABO incompatibility (Mother O, Baby A/B)
Isoimmune hemolytic disease (Rh incompatibility)
G6PD deficiency
Other hemolytic conditions
Sepsis
Clinical instability (previous 24h)
Albumin < 30 g/L
Generate Monitoring Chart
Clear Form
NNJ MONITORING RECORD
TSB Level phototherapy and exchange transfusion (ET)
MOTHER'S NAME:
IC NUMBER:
TIME OF BIRTH:
MOTHER'S BLOOD GROUP:
PERIOD OF GESTATION:
BIRTH WEIGHT:
BABY'S BLOOD GROUP:
DAT/COOMBS:
RISK FACTORS:
MONITORING CHART
DATE
DAYS
BO
PU
TEMP
FEEDING
EXAMINATION
TSB/PL
PLAN
https://tsb.mediklinikmikhail.com
