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27/02/2020 MyHospital Appointment

OPD ASSESSMENT SHEET - CONFIDENTIAL

Name: Age: Sex:

UHID No: Ht: Wt: Date: Time:

Complaint's: Identification Marks:

History:

Past H/O: HO DM BA IHD APD

Drug Allergy Smoking Alcohol

General Examination:

Vital Signs PR: BP: TEMP:

RS -

CVS -

ABD -

CNS -

Pain Level: /10

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