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Presence
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Location
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Location :
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Chief Complaint / Reason for Visit :
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HPI :
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PMH, FamHx, SocHx:
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PMH, FamHx, SocHx changed?
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PMH, FamHx, SocHx changes :
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Change in ROS?
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General [-]
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General
• • •
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General Comments
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Skin [-]
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Skin
• • •
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Skin Comments
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HEENT [-]
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HEENT
• • •
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HEENT Comments
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Neck [-]
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Neck
• • •
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Neck Comments
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Breasts [-]
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Breasts
• • •
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Breasts Comments
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Cardiovascular [-]
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Cardiovascular
• • •
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CV Comments
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Respiratory [-]
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Respiratory
• • •
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Resp Comments
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GI [-]
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GI
• • •
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GI Comments
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Urinary [-]
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Urinary
• • •
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Urinary Comments
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Genital (Male) [-]
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Genital (Male)
• • •
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Genital (Male) Comments
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Genital (Female) [-]
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Genital (Female)
• • •
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Genital (Female) Comments
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Periph. Vasc. [-]
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Periph. Vasc.
• • •
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Periph. Vasc. Comments
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Musculoskeletal
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MSK
• • •
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MSK Comments
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Neurological [-]
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Neurological
• • •
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Neuro Comments
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Endocrine [-]
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Endocrine
• • •
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Endo Comments
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Hematology
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Hematology
• • •
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Allergies/Immunologic other
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