3/16/2024

Mrs. Sandra Nypochamia is pleasant , 30 years old , missionary residing in Santo domingo
Dominican Republic .
Referral . None
source and reliability. Self-referred .

Chief Complaint
“ I have a cough and fever “

Present Illness
Mrs. N reports increasing problems with Coughing and fever issues started a couple days
ago . The patient said she did not remember what she was doing exactly when she first
started coughing . The coughing is constant so it is not frequent . The patient said nothing
made it worse or better but she made it clear it was not an acute pain or coughing . the
patient , because of her religion which is Mormon ; she does walk a lot . No allergie . No
tobacco use . No drug use .She has no idea why she has this coughing and this concerns
her a lot .

Past History
She had hypertension history and her cardiologist prescribed her some medications.She
never been hospitalized , no allergy , seen her obstetrician frequently ,

Family History
her mother is alive , her father died recently .They have no genetic disease in the family

Personal and sexual .

Born and Raised in the Dominican Republic , –she lives in an apartment and the bathroom is
inside and she has no ped , she does not drink coffee and drinks no alcohol.not sexually
active . she has a few friend

Review of system

Skin : No rashes or other changes

Head , eyes , ears , noses , throat : no history of head injury eyes or nose
neck : no lump
breast : no lump
respiratory : coughing
cardiovascular : had arterial hypertension before
gastro : appetite good , no anal pain
urinary : no pain during miction
genital : no black spot on the skin
endocrine : no known thyroid disorder