|
NAME
|
LMP
|
|
BP
/
|
WEIGHT
|
|
AGE
|
GRAVIDITY
|
|
PARITY
|
PREGNANCY TEST
|
|
PREOP DIAGNOSIS
|
MEDICATIONS
|
|
ANESTHESIA
|
birth control method
|
|
EXTERNAL GENITALIA
|
EXTERNAL GENITALIA COMMENTS
|
|
VAGINA
|
VAGINA COMMENTS
|
|
VISUALIZATION
|
|
|
CERVIX
• • •
|
O CLOCK
• • •
|
|
BIOPSY SITE
• • •
|
PROCEDURE
|
|
POSTOP DIAGNOSIS
|
POSTOP CARE
|
