Complete Medical History
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Complete Medical History
DATE :Tuesday, October 25, 2005
GENERAL DATA: Name of patient, age, sex, civil status, nationality, occupation, religion, birth place, presently residing, sought consult to our clinic on date CHIEF COMPLAINT: Cough, Cold, and Fever for 2 days HISTORY OF PRESENT ILLNESS: �Chronological recording of Data� �
Date, time of onset of chief complaint
�
mode of onset
�
precipitating
�
exact anatomical location (if applicable)
�
severity
�
character
�
number of times
�
method/agent of relief
factors
DATE :Tuesday, October 25, 2005
GENERAL DATA: Name of patient, age, sex, civil status, nationality, occupation, religion, birth place, presently residing, sought consult to our clinic on date CHIEF COMPLAINT: Cough, Cold, and Fever for 2 days HISTORY OF PRESENT ILLNESS: �Chronological recording of Data� �
Date, time of onset of chief complaint
�
mode of onset
�
precipitating
�
exact anatomical location (if applicable)
�
severity
�
character
�
number of times
�
method/agent of relief
factors
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