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Mobility
ADLs
General All WNL
General Normal
• • •
General Abnormal
• • •
General Comments
HEENT All WNL
HEENT Normal
• • •
HEENT Abnormal
• • •
HEENT Comments
Skin All WNL
Skin Normal
• • •
Skin Abnormal
• • •
Skin Comments
Neck All WNL
Neck Normal
• • •
Neck Abnormal
• • •
Neck Comments
Cardiovascular All WNL
Cardiovascular Normal
• • •
Cardiovascular Abnormal
• • •
Cardiovascular Comments
Lungs All WNL
Lungs Normal
• • •
Lungs Abnormal
• • •
Lungs Comments
Abdomen All WNL
Abdomen Normal
• • •
Abdomen Abnormal
• • •
Abdomen Comments
GU Male All Normal
GU Male Normal
• • •
GU Male Abnormal
• • •
GU Male Comments
GU Female All Normal
GU Female Normal
• • •
GU Female Abnormal
• • •
GU Female Comments
MSK All WNL
MSK Normal
• • •
MSK Abnormal
• • •
MSK Comments
Breasts All WNL
Breasts Normal
• • •
Breasts Abnormal
• • •
Breasts Comments
Neuro All WNL
Neuro Normal
• • •
Neuro Abnormal
• • •
Neuro Comments
Extremities All WNL
Extremities Normal
• • •
Extremities Abnormal
• • •
Extremities Comments
Endocrine
Endocrine Normal
• • •
Endocrine Abnormal
• • •
Endocrine Comments
Wound #1
Wound #2
Wound #3
Wound #4

Major PE Medical Form

Family Practitioner

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Published: July 26, 2023, 5:30 p.m.
Doctor: Dr. History Physical
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