CASE STUDY FORMAT

I. Introduction
II. Midwifery Goals
III. Health History

A.) Biographic data

 Name:
 Age:
 OB Score:
 Date of birth:
 Gender:
 Marital Status:
 Address:
 Religion:
 Occupation:
 Source of Medical Care:
 Health Care Financing:
 Date of Admission:

IV. Chief complaint

V. History of Present illness
VI. History of Past illness
VII. Family History
VIII. Lifestyle
IX. Social Data
X. Environmental Data
XI. Psychological Data
XII. Spiritual/ Moral Data
XIII. Developmental Theory by Eric Erickson
XIV. Pattern of Health Care
XV. Evaluation

PHYSICAL ASSESSMENT
ANATOMY AND PHYSIOLOGY
DISCUSSION OF THE DISEASE
PATHOPHYSIOLOGY
LABORATORY EXAMS
MIDWIFERY CARE PLAN
DRUGSTUDY
EVALUATION