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P A T I E N T N A M E : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ B I R T H D A T E _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
H E I G H T : _ _ _ _ _ _ W E I G H T _ _ _ _ _ _ B P _ _ ___ / ______ PULSE ______
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NormalAbnormalCommentHEART Rhythm (Regular/Irregular) Murmur (supine) Murmur (standing)ENTLungsSkinAbdominalGenitaliaMusculoskeletal Neck Shoulder Elbow Wrist Hand Back
Scoliosis?
Knee Ankle FootDentalOther
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