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General/Constitutional WNL
Gen/Cons. Abnormal
• • •
Additional Comments:
Neuro WNL
neuro normals click n pick
• • •
Neuro Abnormal
• • •
Additional Comments:
Vascular WNL
vascular normals click n pick
• • •
Vascular Abnormal
• • •
Vascular Comments
Lymphatic WNL (popliteal nodes - )
Gait/Biomechanical WNL
New Field
• • •
Gait Abnormal:
• • •
Additional Comments:
Orthopedic: WNL
ortho normals click n pick
• • •
Orthopedic Abnormals:
• • •
Additional Comments:
Imaging Report/Review?
73610: 3 Views Left Ankle
73610: 3 Views Right Ankle
73630: 3 Views Left Foot
73630: 3 Views Right Foot
Imaging Findings:
• • •
Imaging Comments
Derm: WNL
Derm Abnormals:
• • •
Additional Comments:

Letter to Patient Medical Form

Podiatrist

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Published: Aug. 10, 2022, 1:09 p.m.
Doctor: Dr. History Physical
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