Semester 4

Physical Examination

Practical Report on “History Taking”

Name:

Student ID:

Date:

Time:

Signature:

I. Particulars of the patient (Personal details)

II. Chief complaints

III. History of present illness (HOPI)

(This is the most important part, and this paragraph must include all the facts discussed in the
lecture. I want you to try it on your own, not copying from others, please practice well this part.)

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IV. Past medical and surgical history

V. Family history

VI. Psychosocial history

VII. Systemic review