PATIENT’S PROFILE DATE OF ADMISSION: March 29, 2019
ADMITTING PHYSICIAN: Leo Francis s. Diaz M.D.
A. DEMOGRAPHIC DATA
INITIAL DIAGNOSIS: Intertrochanteric fracture
NAME: Patient Burjol
CHIEF COMPLAINT: Left pelvic pain
AGE: 30 years old
GENDER: Male
ADDRESS: Madayegdeg, San Fernando, La Union
BIRTHDAY: May 1, 1988
OCCUPATION: Carwash
CIVIL STATUS: Married
RACE: Asian
NATIONALITY: Filipino
CULTURE: Ilocano
RELIGIOUS ORIENTATION: Roman Catholic
EDCUATIONAL ATTAINMENT: High school graduate
TIME OF ADMISSION: 5:55 pm
B. HISTORY OF PRESENT ILLNESS Patient Burjol is a father of two , namely, Boriche as the eldest
and Pukong. Burjol is a carwash attendant and is married to Borxa
Hours PTA who works as a sales clerk at a shopping mall located at San
The patient was doing some work. While loading the heavy Fernando city, La Union. Burjol stays at their family owned house
equipment back into the truck, they didn’t notice that the tire pot and states that he doesn’t have issues with his relatives and
was not properly aligned. As when the heavy equipment was about neighbors.
to fall, the patient was around the area and got hit by a part of the
heavy equipment. Being a minimal wager, Burjol only finished highschool. He
tried to pursue finishing college but due to financial problems he
C. PAST HEALTH HISTORY wasn’t able to finish atleast two semesters. He states that he is a
very hardworking and once got an award as an achiever when he
The patient has no known allergies in foods, drugs, animals, was still studying and says that he gets along well with his
insect bites, bee stings etc. He usually takes paracetamol for fever, classmates. He doesn’t smoke and drink.
ibuprofen for pain, amoxicillin for infections, antacids for
hyperacidity.
The patient doesn’t have any history of communicable
illnesses, injuries, and accidents, blood transfusions, and surgical
procedures.
The patient claimed that he suffered from chicken pox when he
was 14 years old. He claimed that he underwent childhood
immunizations but couldn’t recall the exact shots taken.
D. FAMILY HISTORY
Patient’s father is (-) hypertension while his mother is (+) from
hypertension. Among from the 7 siblings, the 3rd born is (+) on
asthma.
E. SOCIAL HISTORY OF THE PATIENT