NO.,
.

wet,

SEX

WEIGHT

PAST
RISTORT

pala
INJURIES

SLOOD PRESSURE

CENTIMETERS

HEART

ae

6

TT

3M

Te
a? F

LUNGS

al '63

SKIN

120/70 163

Hansen's disease)

110/70

IMP 3/7/64.
Para. 5,grav. 4.

Gu or Gyn

Gr. IV dies. M.

URL

Menarche age 13.

ABDOMEN
EENT

145/50
cardiomegaly

145

21M

&

146

10/70

Pain in jointe.

Pterygium left

Scars of

aye ‘63.

Arcus 2+, rt
pterygium

Hansen's
disease.

Menses, 40
pelvic exam.

Papilloems
of neck and
trunk.

Bilat inguinal

ie

49M

let Left toe
deformed 1963.

56M

18 F

82
& M

823

20 M

Menarche age 15.
LMP Mar. 1964
Para. 1,greav.l.

and rt. arm scar
Pig. scar back

Arcus 2+, Rt.
pingueculse, left
pterygium, rt.
Prostate 1+.
eetaract, left
opacity.

1/2" diam.
raised lesions 1
front of chest,
1. arm and leg.
(Pungust ).

Mitral systolic
M
106/70

1 ear from “Beta

Rt. adnexa
thickened.

Mole left
breast.
Vaccination
|scer rt. arm

Arcus 4+.

URI

139

115/60

ll '62

82/50 ‘62

Menarche age 7.
Pare. 6,grev. 5.

LM P 2/25/6h.

134 ‘63

827
a M

2s M
Menarche age 12

LMP Sept. '63

Para. 7,grav.6
lactating.

830
25 M

Abd. Pain

38

Bilat Pteryeium
choroidal atroplly, Prostate
lenticular
enlarged '63.
opacities.

113 «'63

oT F

2h M

9

112/68

826

831

120/80
Extrasystoles

132
128 '63

21 M

25 F

126
135 '62
129 '63

Old facial
paralysis '63.

825

29

scar. Rt. abd.

Arcus 2+,
Bilat.

pingueculas.

30

81

130/80

133

Rt. pterygium.
Exophoria.

Liver edge down
Lom

104/60 '43

j

90/6.

Bleeding qums.

127

114/78

Corneal scars.
Tarcat
inflasmed.

6

115/70

Throat inflamed.

un

100/68

Throat inflamed.

151

106/60

132

110/60

Lai '63

.

'63,

cervical
errosion? '63,

Rte. tonsil
inflLacmed.

Lat. cervical
tears.

Patchy

depigmentaticn.

Impetigo scar
over pubis.

Severe cervical
lacerations.

Select target paragraph3