Medical Case Report
| Name | Purpose | Dosage | Frequency | |
|---|---|---|---|---|
| 1 | Vitamins and Supplements | Maintaining health | 1 tablet | Daily |
| 2 | Calcium | Maintaining health | 1 tablet | Daily |
| 3 | Celestamine | For allergy attacks | 1 tablet | As needed |
| Temperature | Blood Pressure | Heart Rate | Respiratory Rate | |
|---|---|---|---|---|
| 1 | 37.0 | 140/90 | 85 | 22 |
| Normal | Abnormal | Remarks | |
|---|---|---|---|
| Sensory | |||
| Cardiovascular | Irregular heart rhythmn | ||
| Respiratory | Hard to breath at times | ||
| Digestive | |||
| Skin/Integumentary | Edema on right foot | ||
| Bone | |||
| Spinal Cord | |||
| Neurological | |||
| Joints |
| None | Yes | I'm not sure | |
|---|---|---|---|
| Eye problems | |||
| Seizures | |||
| Epilepsy | |||
| Hearing problems | |||
| Diabetes | |||
| Cardiovascular disease | |||
| History of Stroke | |||
| Respiratory problems | |||
| Kidney problems | |||
| Stomach ad liver problems | |||
| Pancreatic problems | |||
| Anxiety and depression | |||
| Other mental health issues | |||
| Sleep disorders | |||
| Neck or back problems |
| Procedure Name | Purpose | Result | |
|---|---|---|---|
| 1 | Chest X-Ray | Check lungs | Normal |
| 2 | Urinalysis | Check urinary tract | Normal |
| 3 | Fecalysis | Check for infection | Normal |
| 4 | Kidney Test | Check functionality | Normal |
| 5 | Ultrasound | Check position | Enlarge |
| 6 | |||
| 7 | |||
| 8 |
Medical Case Report is a research document that is created by the health care team that deals with a specific disease that includes the symptoms, the diagnosis, medical history, patient details, and the treatment. This document is very important for the health care industry because it will be used to further strengthen their medical knowledge and use as proof or evidence about the medical care they will provide to their patients.
This Medical Case Report shows the patient information, the chief complaint, current medical history, medication history, family history, physical examination, review of body systems, vital signs, current medical condition, diagnostic examinations, and treatment. This PDF template is utilizing the Input Table in order to display the data in a table format which makes it easier to read, compare, and understand. This PDF template also displays the name of the author of the document which is usually the assigned physician of the patient being described in the report.
Short Medical History
Medical History Record PDF template is mostly used in order to provide significant information about the health history, care requirements, and risk factors of the patient to doctors. It is for collecting data from the patients.
First Aid Incident Report Template
Incidents must be reported and recorded to be sure that correct actions and treatment are made which should trigger management awareness and an investigation. The First-Aid Incident Report template contains injured person's personal details and contact details, the details and visible symptoms of injury, the Glasgow Coma Scale which is a neurological scale that expects to give a dependable and target method for chronicle the condition of an individual's awareness and brief information of treatment. Also, it contains the profile of the first-aider and signature of the person who prepares the report.
Dietary Requirements Template
Collect important information about food restrictions and allergies. Save submissions as PDFs. Easy to customize, download, print, and share with kitchen staff.
Dental Health Record Template
The Dental Health Record Template is easy for patients to fill out and designed to get the doctor the most important information. Patients can fill out their information on a computer or tablet using our Dental Health Record Template.
Child Medical History Template
This child medical history PDF template makes checking patients vitals and recording that important data easy. Add your own branding, adjust fields for your specific needs and then simply print out your PDF for the patient's file.
Patient Medical Record Template
Medical History Record PDF template lets you collect the patient's data such as personal information, contact information in an emergency case, general medical history. By using this sample, the doctor ensures the patient's better care and treatment.
These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.