H&P (Blank Template), Exams of History

Download H&P (Blank Template) and more Exams History in PDF only on Docsity! H&P (Blank Template) January 1, 2050 Name: _____ Age: ____ Sex:____ Chief Complaint (CC): History of Present Illness (HPI): Past Medical History (PMH): Illnesses/Diagnosis Medication Allergies Hospitalization Operations SH: Social history FH: Family history • Mom – • Dad – ROS: Review of Systems • Constitutional – • Eyes – • ENT – • Skin – • Cardiovascular – • Pulmonary – • Endocrine – • Gastrointestinal – • Genitourinary – • Musculoskeletal – • Neurologic – • Psychology – • Heme/Lymph – VITALS: 1. Temperature – 2. Heart Rate – 3. Respiratory Rate – 4. Blood Pressure – 5. Pulse Oximetry – 6. Pain Scale – PHYSICAL EXAM: • General – • HENT – • Eyes – • Cardiovascular – • Pulmonary – • Abdominal – • Neurological – • Extremities: no edema, erythema, openings, or lacerations