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Primary Care Physician
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Referring Physician
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Reason for Visit
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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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Medical History
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Medical History
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Past Surgical History
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Past Surgical History
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Surgical History
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Social History
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Social History
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Tobacco Use
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Alcohol and Illicit Substance
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Other substances
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Family History
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Family History
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Review of the Systems
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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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Periph. Vasc. [-]
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Periph. Vasc.
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Periph. Vasc. Comments
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MSK [-]
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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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Psychiatric [-]
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Psychiatric
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Psychiatric Comments
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Physical Exam
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New Short Text Field
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Physical Exam
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Physical Exam
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New Short Text Field
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General WNL
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General Abnormal
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General Comments
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HEENT WNL
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HEENT Abnormal
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HEENT Comments
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Neck WNL
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Neck Abnormal
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Neck Comments
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Cardiovascular WNL
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Cardiovascular Abnormal
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Cardiovascular Comments
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Chest WNL
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Chest Abnormal
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Chest Comments
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Abdomen WNL
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Abdomen Abnormal
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Abdomen Comments
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MSK WNL
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MSK Abnormal
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MSK Comments
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Breasts WNL
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Breasts Abnormal
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Breasts Comment
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Neuro WNL
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Neuro Abnormal
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Neuro Comment
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Extremities WNL
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Extrem Abnormal
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Extremities Comment
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Genitourinary WNL
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Genitourinary Comment
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Heme and Lymphatics WNL
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Heme and Lymphatics Comment
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Laboratory Data
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Imaging Studies
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Diagram
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Assessment
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Plan
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Education
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General Instructions
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Labs
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Labs
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Radiology
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Imaging Studies
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Referrals
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Follow Up
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Follow Up
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cc
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Disclaimer
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Disclaimer
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Disclaimer
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Disclaimer
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Disclaimer
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Disclaimer
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