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Chief Complaint
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History of Present Illness:
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Past Medical History
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Past Surgical History
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Allergies/Intolerances
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CARDIOVASCULAR CHECK
• • •
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ROS
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Recent Hospitalizations:
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Medication Reconciliation
• • •
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Reviewed
• • •
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Physical Exam
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ASSESSMENT
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PLAN
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Labs/ Studies
• • •
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Lab Comments
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