Patient Notes
Date:
Student Name:
Patient Number:
HISTORY
– Include significant positives and negatives from history of present illness, past medical history, review of system(s), social history, family history, medications and allergies.
950 Character Limit
PHYSICAL EXAMINATION
500 Character Limit
DIFFERENTIAL DIAGNOSIS -
In order of likelihood
(with 1 being the most likely), list up to 5 potential or possible diagnoses for this patient's presentation (in many cases, fewer than 5 diagnoses are likely):
1.
2.
3.
4.
5.
DIAGNOSTIC WORKUP
- List immediate plans (up to 5) for further diagnostic workup:
1.
2.
3.
4.
5.
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