| Let’s record events during hospital stay |
| Course during hospital stay |
| Hospitalization period: From yr. mo. day to yr. mo. day |
| Duration of incubating period ( days) |
| Diagnosis |
| Oxygen administration: Yes/no( days) |
| Mechanical ventilation: Yes/No( days) |
| Jaundice treatment: Yes/No |
| Exchange transfusion: ( times) |
| Intracranial hemorrhage: Yes/No |
| Periventricular leukomalacia (PVL): Yes/No |
| Convulsion: Yes/No (status, cause treatment, etc.) |
| Surgery: Yes/No |
| Other complications |
| When you transfer to another hospital, record the state after transfer in this column |