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Idb Form

This document contains a template for collecting initial data on families as part of family nursing practice. The template includes sections to record information on family structure, characteristics, socioeconomic factors, culture, education, nationality, relationships, income sources, residency, birthdays, marital status, gender, age, occupation, workplace, religion, ethnicity, and identifies the head of household.

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756 views1 page

Idb Form

This document contains a template for collecting initial data on families as part of family nursing practice. The template includes sections to record information on family structure, characteristics, socioeconomic factors, culture, education, nationality, relationships, income sources, residency, birthdays, marital status, gender, age, occupation, workplace, religion, ethnicity, and identifies the head of household.

Uploaded by

mikasheep
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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UNIVERSITY OF SANTO TOMAS College of Nursing Initial Data Base for Family Nursing Practice Family Name: Head

of Family: Address: I. II. Family Structure & Characteristics Socio-Economic & Cultural Factors Educational Attainment Nationality Relation to Head Other Sources of Income Residency Birthday Marital Status Gender Age Month Year Occupation Type of Place Work Remarks Barangay: Health Center:

Religion

1*

No. 1 Family member should be Head of Family

Income

Ethnic Group

FAMILY MEMBER No. Name

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