(a) Enter the month and year (the month and year of the first set of vital
signs recorded in the first column of that side of the form) under the words "Month-
(b) Enter the day of the month in the row of blocks horizontal to the
words "Month-Year/Day" and under the "Post- Day" row.
(4) Hour. Enter the time that the patient's vital signs are taken (not
recorded) under the calendar date row. The block under each calendar date is divided
in half to represent the AM and PM hours. Each half is then divided into thirds by two
dots. Since each "day" is divided into six columns and there are twenty-four hours in a
day, this allows vital signs to be recorded once every four hours (the normal schedule).
(a) Use civilian time, not military time, in completing this section. For
instance, a patient whose vital signs are to be taken at 0200, 0600, 1000, 1400, 1800,
and 2200 would have "2.6.10" entered in the AM half of the block and would also have
"2.6.10" entered in the PM half. This is referred to as a "2.6.10" schedule. Another
version of the four hour interval schedule is the "4.8.12" schedule.
(b) Vital signs may be taken every four hours, less often, or more often
depending upon the needs of the patient and the physician's orders. If a patient's vital
signs are to be taken more often than every four hours, additional columns may be
used. If vital signs are taken every two hours, for example, use one complete "day"
column for the AM readings and another "day" column for the PM readings. Enter the
appropriate times in the heading. The calendar and post-op/partum day entries must
also appear in the appropriate blocks.
(5) Examples of headings. Sergeant Jones underwent surgery on 16
September 199X. His vital signs are taken on a 2.6.10 schedule.
(a) The heading on Sergeant Jones' SF 511 would be:
The actual time of the admission vital signs (0400) is entered vertically in the