PeDuaTRic WstORY SOURCE OF ASTOR name shee Sen {bate of Admiton + Nationality TE: NOTRTION HISTORY * Bote or breast fed How long?) ‘Timing ofintoduction of sos cereals “ Giren etary intake Any ctr esticions?} + bots fed (ype = Preparton = Volume = Duration ~ Frequency Tota daly tae) SLMAIN COMPLAINT & DURATION. - HISTORY OF PRESENTING KANESS [HP (heck he nee) ‘slate ofonset) character), Assocateds} fume), Elerscerbotngareeving fats). lerety) Review fretted system, fd exer.» Rik factors. Previous episodes * rsmusizatin ad (uptodate?) ‘ifrotecees (uh) + Alors or side effets from any acne + tet acing taken TS FOBPTAL COURSE * What happened since admission: Improving) worsening Ivstiations done + frdngs + meseaton gen + New constants + New aagnoss + lan orsvsc for hospital sty) Grou motor > Fine mor Rvs» Soil + speech & Hearing TECMEDICATION HISTORY: Name Duration +0o%e 1 ice tec? TE aVsTEMIC REVIEW * General y= Weight lors Poor Feeding —Fovee—Pallor—Lethacay tos Drpnes~ suey on fending Slow fo feed ~ Cyan. ‘Rerpatone Sore throat eat teh =Cauph (ry opr) Hematemess— weezer yspnes Frequent chert inectons - Stidor Noe reat ‘Git: Aggette— West loss nausea [Vomiting -Hematrsess|~Abdorial pin lnundie~Dahes~Consipation~Slond/ Mucus in stool change in tol alt ‘ Gentouinary: Frequency ~Enuress (ry ding dy tine? ~ Noctua ~ ysuraering Gurngictrton)Hematura- Anoral pela - Urine calor change Ns: Dzzness ~Newousess is (convulsion, Drowsiness ~ Weakness, Cunsies IIH a ing gether, Sores) 1 Sehootng Which school What sort evel ~ Grades) 1 Does the patent mz cna? How frequent? (© How does eget on wth tne ciren? Etec ofhis cron illness on hi col performance + Financiabupport 2) ‘Travel tory TS FAMILY HISTOR * Snr ness in fary ‘ving where? * slings (number age sex~order~ heal a) 1 Parents (Age ~ Eeaion ~ Occupation ~ Income ~ Oeave ~ Consanguinity Soin ‘Momatlogy: Epistasis~ Easy broking ~ Circumcision teeing ‘endocrine __Polyuis Papa Polphags + Metical (Disease or Mediation soni gp toast part Name sige ose {Main complaints Ourstion + Known nese ‘Asscatedsymatoms + mpertant rings (ependon the case) vs sugeal Hoag Admins aod Trantusion ‘Antenatal Pregnancy (Completion rugs Radiation) Gestation oH rata Oat eg tune) Acmiason special care Ventlaton Oscharged (wth mom stayed why) 1 sory of any chron dsease) (since when? {© Diagnosefllowirg up in which hospital? Doctor? (© What were the presenting smotors? (© what investigations were dane ta cone the diagnosis? (© Medeations being usd Surgeries were done 1 Improving / Worsening wth he medeation (© Hospital Admission / PICU atmision (© complications? Follow up in ther isto wea the complications