Last PAP smear more than 10 years ago Does monthly breast exams History of one

Last pap smear more than 10 years ago does monthly

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was 4 months ago. Last PAP smear more than 10 years ago. Does monthly breast exams. History of one child stillborn. Family History (Fam Hx) - Includes but not limited to illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent. Maternal grandparents: history of CAD and DM type II Paternal grandparents: history of obesity, CVA and HTN Mother: deceased at age 88, hx of HTN and DM type II Father: deceased at age 82, hx of htn and Hypercholesteromia Son: Healthy age 48 Daughter: healthy age 46 One still born child via csection Review of Systems (ROS): Address all body systems that may help rule in or out a differential diagnosis Check the box next to each positive symptom and provide additional details. Constitutional Skin HEENT Fatigue Low energy, missing the aerobics classes Weakness Low energy and missing aerobics classes Fever/Chills Click or tap here to enter text. Itching Click or tap here to enter text. Rashes Click or tap here to enter text. Nail Changes Click or tap here to enter text. Skin Color Changes Diplopia Click or tap here to enter text. Eye Pain Click or tap here to enter text. Eye redness Click or tap here to enter text. Vision changes Click or tap here to enter text. Earache Click or tap here to enter text. Tinnitus Click or tap here to enter text. Epistaxis Click or tap here to enter text. Vertigo Click or tap here to enter text. Hoarseness Click or tap here to enter text. Oral Ulcers Click or tap here to enter text. Sore Throat Click or tap here to enter text. Congestion Click or tap here to enter text.
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Weight Gain Click or tap here to enter text. Weight Loss Click or tap here to enter text. Trouble Sleeping Click or tap here to enter text. Night Sweats Click or tap here to enter text. Other: Click or tap here to enter text. Click or tap here to enter text. Other: Click or tap here to enter text. Photophobia Click or tap here to enter text. Eye discharge Click or tap here to enter text. Hearing Changes Click or tap here to enter text. Rhinorrhea Click or tap here to enter text. Other: Click or tap here to enter text. Respiratory Neuro Cardiovascular Cough Click or tap here to enter text. Hemoptysis Click or tap here to enter text. Dyspnea Click or tap here to enter text. Wheezing Click or tap here to enter text. Pain on Inspiration Click or tap here to enter text. Sputum Production Other: Click or tap here to enter text. Syncope or Lightheadedness Click or tap here to enter text. Headache Click or tap here to enter text. Numbness Click or tap here to enter text. Tingling Click or tap here to enter text. Sensation Changes Speech Deficits Click or tap here to enter text.
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