Surgery H&P Template

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ID

CC

____________________________________________________________________________
HPI

____________________________________________________________________________
PMHx
GenHealth

Illnesses

Admissions

PSHx

Meds

ROS
Skin

LN

HEENT

Breasts

CV

Resp

GI

Endocrine

Immuno/Allergy

MSI

Neuro/Psych

FHx

SocHx
EtOH
Tobacco
iliicit

Allergies

PhysicalExam
Vitals

General

Integument

LN

HEENT/Mouth

Neck

Breasts

Lungs/Thorax

CV

Abdomen

GU

GI

MSI

MS

Neuro

AdmitLabs

DDx
1.
2.
3.
4.
5.
6.
7.
____________________________________________________________________________
Plan

HospitalCourse

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