I.

PATIENT HISTORY
1. Chief report of symptoms.
a. OLDCART.
2. History of present illness.
3. History of past illness.
4. Functional history.
a. Communication.
b. Bathing.
c. Dressing.
d. Toileting.
e. Transferring.
f. Going to toilet.
g. Eating & drinking.
5. Personal history.
a. Psychological & psychiatric history.
b. Diet.
c. Drinking, smoking and drug.
6. Social history.
7. Vocational history.
a. Vocational ADL.
b. Avocational ADL.
8. Family history.
II. PHYSICAL EXAMINATION
1. Vital sign & general appearance.
2. Head-to-toe examination.
3. Musculoskeletal:
a. Inspection.
b. Palpation.
c. Muscle strength testing.
d. ROM assessment.
e. Joint stability.
III. NEUROLOGIC EXAMINATION
1. Level of consciousness:
a. Orientasi & Memori.
b. Konsentrasi & Kalkulasi.
c. Intelegensi baca & tulis.
d. Tilikan diri.
e. Coping & Stressor.
2. Cranial nerves.
3. Physiologic and pathologic reflexes.
4. Motoric & sensoric examination.
5. Equilibrium examination.
IV. FUNCTIONAL STATUS EXAMINATION
V. SUMMARY