80

WEIGHT
NO.,
AGE,

PAST

SEK

29

HISTORY

etewe
INJURIES

CENTIMETERS}

BLOOD PRESSURE
HEART

&

ABDOMEN

LUNGS

EENT

110

75 2 M

Blind in left
eye. Right eye
air
fair.

110/64
Pulse 8, reg.

34

Menopause -hys-

126

106/70

1e5 '62

110/60 '62

134

115/60

146

120/70

Arcus 1+.

90/60 '62

Corneal scar
left eye '63.

terectany "hg,
Para. 14, grav.
10.Pain in legs.

55 F

Gu or Gyn

Rt
hyper“mature
Lett aphakia.
;
‘

.
Prostate 2+,
firm left lobe '

Arcus 4+, Left

|Mid-line surg.

pterygium. Rt.

|scar. Erosion

pingueculae.
of cervix.
1+ retinal ecler+
osis.

SKIN

Numerous nevi
on shoulders ‘
Pigmented moles

back and neck.

35

23M

36

.

18 M

37
30 M

39
-

109 "62

25 F

ho

Fistula in ano

Traumatic deform-

gically '6h).
Low back pain.

finger.

(corrected sur-

39 M

42

Lump right arn.

54M

ity right index

Throat alight

Tinea, circinata

inflammaticn.

pack, abd.,

legs and arms.

Bilat.pingueculae.

S51.

roughening

and pig. back of
neck, Pig. var.

and sl.hyperpig.
dorsum right

foot,

125

115 '63

110/70

116

110/70

68

130/72

Arcus 2+.

Pingueculae and
exophoria.

Fistula in ano

|with perirectal
absceas '63.
Leukoplakia '63.

Dermatitis

right hand.

Arcus 3+.2+ ret?
inal arteriosclerosis. Circump+
papillary ring of
choroid degeneraP
tion.

Menopause: time

43

unknown. Para.

h, ? grav. 4,

76 F

45

Menarche age 13.

42 F

11, grav. 9. Low

LMP 3/7/64. Para.

18 M
Menarche age 13.
IMP 2/5/64, Para.
6, grav. 3. Pain

hg
25 F

4h M

51

Menarche age 17.

35 F

Para. 2, grav. 0.
LMP 3/7/64.

55

Backpain, Blindness, partial.

85 M

cataracts

Throat slight

Arcus 2+. Left

117

120/70

135

110/70

Throat slight
inflammation.

166
137 '63

96/64

Rt. paramedian
Throat inflamed.| scar. Severe lat] Pig. macs.
cervical tears,
both aides of

in Joints, obese,
URI.

50

Bilet. pterygium

Bilat.

inflammation.

back pain.

AT

c

Grade I sys. m.

pingueculae.

Right pterygiun.

1x3 cm. cervical|
erosion.

185

120/70

99

90/60

Arcus 3+. Scar

mf.

3

rt. arm (not

"beta burns"),

Healed cervical
tear. Bartholin

100/65

Pulse 86, reg.

4+ arcus. Blind,

partial. Throat
inflamed. Node
left neck.

Cataract OD) _.¢4
Aphakia 0D}

5 0 L bey

Sears on upper

nose septum.

cyst left labia.

134 61

neck, ACF.

Prostate 1+.

Mole on
abdomen.

Select target paragraph3