| PE - WNL | Full PE - WNL | 
| PE - BHRT/Brief PE - normal | PE - pap Normal | 
| General - WNL | General - Normal• • • | 
|  | Patient Annotations | 
| Head / Neck - WNL | Head/Neck - Normal• • • | 
|  | Patient Annotations | 
| Eyes - WNL | Eyes - Normal• • • | 
|  | Patient Annotations | 
| Ears - WNL | Ears - Normal• • • | 
|  | Patient Annotations | 
| Nose / Mouth - WNL | Nose / Mouth - Normal• • • | 
|  | Patient Annotations | 
| Lungs - WNL | Lungs - Normal• • • | 
|  | Patient Annotations | 
| Cardiovascular - WNL | Cardiovascular - Normal• • • | 
|  | Patient Annotations | 
| Musculoskeletal - WNL | Musculoskeletal - Normal or abnormal• • • | 
|  | Patient Annotations | 
| Abdomen - WNL | Abdomen - Normal• • • | 
|  | Patient Annotations | 
| Breast - WNL | Breast - Normal• • • | 
|  | Patient Annotations | 
| Genitourinary - Female - Normal | Genitourinary Female - Normal• • • | 
|  | Patient Annotations | 
| Skin - WNL | Skin - Normal or abnormal• • • | 
|  | Patient Annotations | 
| Neuro - WNL | Neuro - Normal• • • | 
|  | Patient Annotations | 
| Psychiatric - WNL | Psychiatric - Normal• • • | 
|  | Patient Annotations | 
| Picture Relevant to Visit |  | 

