Transfusions (number of units for each component):
Packed red blood cells	Preoperative:		Intraoperative:		Postoperative:
Platelet concentrate	Preoperative:		Intraoperative:		Postoperative:
Fresh frozen plasma	Preoperative:		Intraoperative:		Postoperative:
Other blood component: ___________________	Preoperative:		Intraoperative:		Postoperative:
Indication code for transfusion (see Appendix 4)