Name: Age: Gender: Civil Status: Religion: Birthday: Birth Place: Nationality: Address: Occupation: Phic: Case: Date & Time Admitted: Chief Complaint: History of Present Illness
Name: Age: Gender: Civil Status: Religion: Birthday: Birth Place: Nationality: Address: Occupation: Phic: Case: Date & Time Admitted: Chief Complaint: History of Present Illness
Name: Age: Gender: Civil Status: Religion: Birthday: Birth Place: Nationality: Address: Occupation: Phic: Case: Date & Time Admitted: Chief Complaint: History of Present Illness
FAMILY HISTORY:
Patient has no family history of hypertension, stroke, heart disease, Diabetes Mellitus,
coronary artery disease, bronchial asthma, and cancer in both maternal and paternal side.
Patient has a brother who is a hypertensive and a sister diagnosed with breast cancer.