|
Patient Hx
|
|
Patient physical
|
|
|
|
Hx of Alcohol use
|
|
|
|
Hx of Allergies
|
|
|
|
Hx of Childhood diseases
|
|
|
|
Hx of Cogn func
|
|
|
|
Hx of Functional status
|
|
|
|
Hx of Growth+Development
|
|
|
|
Family member diseases Hx
?
|
|
|
|
Hospital discharge Hx
|
|
|
|
Hx of Hospitalization
|
|
|
|
Hx of Industrial exposure
|
|
|
|
Hx of Major illnesses and injuries
|
|
|
|
Hx of Medication use
|
|
|
|
Hx of Occupation
|
|
|
|
Hx of Occupational exposure
|
|
|
|
Hx of Other nonmedical drug use
|
|
|
|
Hx of Other social factors
|
|
|
|
Hx of Outpt visits
|
|
|
|
Hx of Pres illness
|
|
|
|
Hx of Sexual behavior
|
|
|
|
Hx of Social function
|
|
|
|
Hx of Surg proc
|
|
|
|
Hx of Symp + dis
|
|
|
|
Hx of Tobacco use
|
|
|
|
Hx of Travel
|
|
|