| 
               Subjective 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               HPI 
  
  
  
  
 | 
          
            
               Social HX 
  
  
  
  
 | 
          
          
| 
               Family HX 
  
  
  
  
 | 
          
            
               Past Medical HX 
  
  
  
  
 | 
          
          
| 
               General [-] 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               | 
          
            
               | 
          
          
| 
               | 
          
            
               | 
          
          
| 
               | 
          
            
               | 
          
          
| 
               | 
          
            
               | 
          
          
| 
               | 
          
            
               | 
          
          
| 
               | 
          
            
               Breasts [+] 
  
  
  • • •
  
 | 
          
          
| 
               Breasts Comments 
  
  
  
  
 | 
          
            
               Cardiovascular [-] 
  
  
  
  
 | 
          
          
| 
               Cardiovascular [+] 
  
  
  • • •
  
 | 
          
            
               CV Comments 
  
  
  
  
 | 
          
          
| 
               Respiratory [-] 
  
  
  
  
 | 
          
            
               Respiratory [+] 
  
  
  • • •
  
 | 
          
          
| 
               Resp Comments 
  
  
  
  
 | 
          
            
               GI [-] 
  
  
  
  
 | 
          
          
| 
               GI [+] 
  
  
  • • •
  
 | 
          
            
               GI Comments 
  
  
  
  
 | 
          
          
| 
               Urinary [-] 
  
  
  
  
 | 
          
            
               Urinary [+] 
  
  
  • • •
  
 | 
          
          
| 
               Urinary Comments 
  
  
  
  
 | 
          
            
               Genital (Male) [-] 
  
  
  
  
 | 
          
          
| 
               Genital (Male) [+] 
  
  
  • • •
  
 | 
          
            
               Genital (Male) Comments 
  
  
  
  
 | 
          
          
| 
               Genital (Female) [-] 
  
  
  
  
 | 
          
            
               Genital (Female) [+] 
  
  
  • • •
  
 | 
          
          
| 
               Periph. Vasc. [-] 
  
  
  
  
 | 
          
            
               Periph. Vasc. [+] 
  
  
  • • •
  
 | 
          
          
| 
               Periph. Vasc. Comments 
  
  
  
  
 | 
          
            
               MSK [-] 
  
  
  
  
 | 
          
          
| 
               MSK [+] 
  
  
  • • •
  
 | 
          
            
               MSK Comments 
  
  
  
  
 | 
          
          
| 
               Neurologic [-] 
  
  
  
  
 | 
          
            
               Neurologic [+] 
  
  
  • • •
  
 | 
          
          
| 
               Neuro Comments 
  
  
  
  
 | 
          
            
               Endocrine [-] 
  
  
  
  
 | 
          
          
| 
               Endocrine [+] 
  
  
  • • •
  
 | 
          
            
               Endo Comments 
  
  
  
  
 | 
          
          
| 
               Psychiatric [-] 
  
  
  
  
 | 
          
            
               Psychiatric [+] 
  
  
  • • •
  
 | 
          
          
| 
               Psychiatric Comments 
  
  
  
  
 | 
          
            
               New Short Text Field 
  
  
  
  
 | 
          
          
| 
               Objective 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               General WNL 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               General Abnormal 
  
  
  • • •
  
 | 
          
            
               General Comments 
  
  
  
  
 | 
          
          
| 
               Neuro WNL 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Neuro Abnormal 
  
  
  • • •
  
 | 
          
            
               Neuro Comments 
  
  
  
  
 | 
          
          
| 
               Motor Strength WNL 
  
  
  
  
 | 
          
            
               Motor Abnormal 
  
  
  • • •
  
 | 
          
          
| 
               Extrem Comments 
  
  
  
  
 | 
          
            
               | 
          
          
