Case Format No 2

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CASE STUDY

I.

INTRODUCTION A. OBJECTIVE IN PRESENTING THE CASE B. GENERAL INFORMATION PATIENTS INITIALS: A. P. B. HEIGHT: 510 feet WEIGHT: ADDRESS: Boulevard, Brgy 37-D Pob. Davao City AGE: 48 y/o SEX: Male CIVIL STATUS: Single OCCUPATION: NONE NUMBER OF CHILDREN: (IF MARRIED) NONE RELIGION: Roman Catholic NAME OF SPOUSE: NONE EDUCATIONAL ATTAINTMENT: 2nd year ESTIMATED MONTHLY INCOME:____________________________________________________

II.

ANAMNESIS:
A. MATERNAL AND PATERNAL LINEAGE:

B. PARENTS C. SUBJECT

III.

COURSE IN THE HOSPITAL:


A. MENTAL STATUS ON ADMISSION AND SUBSEQUENT MENTAL STATUS: B. PROGESS NOTES AND OTHER OBSERVATION:

IV.

PSYCHODYNAMICS LABORATORY EXAMINATION AND RESULT OF PSYCHOLOGICAL TESTS, IF ANY DIAGNOSIS MEDICAL MANAGEMENT NCP RECOMMENDATIONS AND PROGNOSIS CRITERIA FOR PROGNOSIS 1. ONSET OF ILLNESS 2. CIVIL STATUS 3. PRECIPITATING FACTORS 4. MOOD AND AFFECT 5. ATTITUDE AND WILLINGNESS TO TAKE MEDICATIONS AND TREATMENT 6. SUPPORT SYSTEMS

V. VI. VII. VIII. IX.

7. ANY DEPRESSIVE FEATURE 8. OTHERS

X.

BIBLIOGRAPHIES

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