PHYSICAL EXAMINATION
COOE: 0 - SATISFACTORY:
xX - UNSATISFACTORY
EXPLAIN ALL ITEMS COOED AS X ANO WRITE ALL RECOMMENDATIONS BELOW.
OATE
AGE
WEIGHT
HEIGHT
HEAO CIRCUMFERENCE
CHEST CIRCUMFERENCE
i
7
i
|
{
|
1
!
SKIN
HEAD AND NECK
EENT
VISION
HEARING
HEART 2NO LUNGS
ABDOMEN
GENITALIA
EXTREMITIES
NEUROLOGICAL
NUTAITION
FINDINGS (inci. iab. and
TREATMENT REGIMEN
1
‘
!
|
'
|
i
{
i
1
|
1
|
{
I
i
TEMPERATURE
PULSE
BLOOD PRESSURE
|
|
|
i
r
}
$
|
|