Republic of the Philippines

SULTAN KUDARAT STATE UNIVERSITY

College of Health Sciences
ACCESS Campus, EJC Montilla, Tacurong City

NURSING HEALTH HISTORY

I. PATIENT’S BIOGRAPHICAL INFORMATION

Name:W.F.G

Address: D’Lotilla, Isulan, Sultan Kudarat

Age: 63 years old

Birthday: January 07, 1960

Gender: Male

Nationality: Filipino

Religion: Catholic

Marital Status: Single

II. NURSING HEALTH HISTORY

A. CHIEF COMPLAINT

 Cough and dyspnea

B. HISTORY OF PRESENT ILLNESS

 One week prior to arrival, patient has cough with dyspnea with on and off
fever condition.

C. HISTORY OF PAST ILLNESS

- None

D. FAMILY HISTORY

- None