Complaint
|
|
Historian
|
Relationship
• • •
|
Reliability
|
Collected By
|
Problem 1
|
Problem
|
Onset
|
Onset Units
|
Frequency
• • •
|
Frequency Units
|
Duration
|
Duration Units
|
Severity-Max
|
Severity-Avg
|
T-Max
|
T-Avg
|
Progression
• • •
|
|
Aggavating
|
Alleviating
|
Context
|
Associated
|
Location
|
|
Problem 2
|
Problem
|
Onset
|
Onset Units
|
Duration
|
Duration Units
|
Progression
• • •
|
|
Severity-Max
|
Severity-Avg
|
Aggavating
|
Alleviating
|
Context
|
Associated
|
Location
|
|
Review-General
|
|
General
• • •
|
Constitutional
• • •
|
Ears
• • •
|
Nose
• • •
|
Mouth
• • •
|
Neck
• • •
|
Cardiovascular
• • •
|
Respiratory
• • •
|
Gastrointestinal
• • •
|
|
Derm
• • •
|
Location
|
Review - Extended
|
|
Head
• • •
|
Eyes
• • •
|
Female GU
• • •
|
Male GU
• • •
|
Endocrine
• • •
|
Neuro
• • •
|
Lymphatics
• • •
|
Allergy
• • •
|
Heme
• • •
|
|
RUE
• • •
|
LUE
• • •
|
RLE
• • •
|
LUE
• • •
|