| 
               General Appearance 
  
  
  
  
 | 
          
            
               General Appearance Comments 
  
  
  
  
 | 
          
          
| 
               Head Normal 
  
  
  
  
 | 
          
            
               Head Comments 
  
  
  
  
 | 
          
          
| 
               Ears Normal   
  
  
  
  
 | 
          
            
               Ears Comments 
  
  
  
  
 | 
          
          
| 
               Eyes Normal  
  
  
  
  
 | 
          
            
               Eyes Comments 
  
  
  
  
 | 
          
          
| 
               Eyes Limited 
  
  
  
  
 | 
          
            
               Eyes Comments 
  
  
  
  
 | 
          
          
| 
               Nose Normal 
  
  
  
  
 | 
          
            
               Nose Comments 
  
  
  
  
 | 
          
          
| 
               Oropharynx Normal 
  
  
  
  
 | 
          
            
               Oropharynx Comments 
  
  
  
  
 | 
          
          
| 
               Neck Normal 
  
  
  
  
 | 
          
            
               Neck Comments 
  
  
  
  
 | 
          
          
| 
               Chest Normal 
  
  
  
  
 | 
          
            
               Chest Comments 
  
  
  
  
 | 
          
          
| 
               Cardiovascular Normal 
  
  
  
  
 | 
          
            
               Cardiovascular Comments 
  
  
  
  
 | 
          
          
| 
               Abdomen Normal 
  
  
  
  
 | 
          
            
               Abdomen Comments 
  
  
  
  
 | 
          
          
| 
               Rectum/Anus Normal 
  
  
  
  
 | 
          
            
               Rectum/Anus Comments 
  
  
  
  
 | 
          
          
| 
               Extremities Normal 
  
  
  
  
 | 
          
            
               Extremities Comments 
  
  
  
  
 | 
          
          
| 
               Back Normal 
  
  
  
  
 | 
          
            
               Back Comments 
  
  
  
  
 | 
          
          
| 
               Neuro Normal   
  
  
  
  
 | 
          
            
               Neuro Comments 
  
  
  
  
 | 
          
          
| 
               Skin Normal 
  
  
  
  
 | 
          
            
               Skin Comments 
  
  
  
  
 | 
          
          
| 
               Male Genitourinary 
  
  
  
  
 | 
          
            
               Male Genitourinary Comments 
  
  
  
  
 | 
          
          
| 
               Female Genitourinary 
  
  
  
  
 | 
          
            
               Female Genitourinary Comments 
  
  
  
  
 | 
          
          
| 
               Tanner's stage 
  
  
  • • •
  
 | 
          
            
               Tanner's stage Comment 
  
  
  
  
 | 
          
          
| 
               Reassessment 
  
  
  
  
 | 
          
            
               | 
          
          
