Page 46 - TERMINAL DISCHARGE GUIDELINE FIRST EDITION 2023

Chapter 7
Terminal Discharge Pathway

7.8 Letter for Terminal Discharge

HOSPITAL KUALA LUMPUR TEL: 03-26155555
JALAN PAHANG FAX:

50586 KUALA LUMPUR E-MAIL:
Our Reference:
Date :

Dear Officer Concerned,

RE: DISCHARGE
This letter is to inform that
Patient’s Name : ________________________
NRIC/ID Number : ________________________

Is under the care of ___________ department in Hospital Kuala Lumpur. He/ She is
critically ill and wishes to spend this period at home. Therefore, the patient is
discharged with the following medication:

Medication:
Subcutaneous Morphine _________ Syringes
Subcutaneous Midazolam _________ Syringes
_______________________________________

The medication will be collected by patient’s caregiver.
Caregiver’s Name : ________________________
NRIC/ID Number : ________________________

If you have any queries, please do not hesitate to contact us at
_________________________.
Thank you.

Best Regards,

____________________
Dr. _________________
Medical Officer / Specialist / Consultant
Department ________________
Hospital Kuala Lumpur

HOSPITAL KUALA LUMPUR 46
TERMINAL DISCHARGE GUIDELINE 2023