Chief Complaint and History of Present Illness 3

You might also like

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Chief Complaint and History of Present Illness:

Persistent cough for the last 3 months and in the last 3 days she’s been experiencing chills and
night sweats and today she noticed she was coughing up blood.

Type of Previous Date Type of Previous Date


Illness/ Illness

Pregnancy/Delivery Pregnancy/Delivery

Fever November-10-2020 Vaginal delivery July -18-2020

headache November-2-2020

cough August -5 -2020


November-16-2020

Has received blood in the past: ___ Yes ___ No. If yes, list dates _____Reactions: ___Yes ___ No

Medication Dose/ Time of Last Medicatio Dose/ Time of Last


Name n Name
Frequency Dose Frequency Dose

Paracetamol 500 mg 1 tab PO q4 6:00 pm

Ibuprofen 300mg PO t.i.d 4:00pm

amoxicillin 500mg PO t.i.d 4:30pm

Were you admitted?_________Yes _________No If Yes, where?

Attending Physician:

You might also like