ࡱ> 574Y 5 bjbjWW <6==5]ddddddd$$l44444444~$octd44444dd4444jd4d4~dddd4~~dd~4֒9.~ HEALTH RECORDCHRONOLOGICAL RECORD OF MEDICAL CAREDATESYMPTOMS, DIAGNOSIS, TREATMENT, TREATING ORGANIZATION (Sign each entry)Provider:62nd Medical Group (AMC), McChord AFB, WA, 98438Date:UTI OVERPRINTTime:SUBJECTIVE: ______ year old female here with complaints of: (circle + responses)B/P: painful urination increased urinary frequency blood in urinePulse: back pain fever abnormal vaginal discharge nausea/vomitingResp:Prior Hx of UTIs: none occasional frequentTemp:Ht:Other:Wt:Age:OBJECTIVE: General - Tobacco: YES NO Abdomen - LMP: Back - no CVA tenderness R L CVA tendernessLast Pap: Other exam - Tetanus:Allergies: Lab results:ASSESMENT:Meds:PLAN: Discussed UTIs, advised patient to review section in Healthwise Handbook re: UTIsPREVENTION COUNSELING:Tech:PATIENTS IDENTIFICATION (Use this space for Mechanical Imprint)RECORDS MAINTAINED AT:PATIENTS NAME ( Last, First, Middle initial )SEX RELATIONSHIP TO SPONSOR: STATUSRANK/GRADESPONSORS NAME ORGANIZATIONDEPART./SERVICE SSN/IDENTIFICATION NO.DATE OF BIRTH62nd MDG UTI OVERPRINT CHRONOLOGICAL RECORD OF MEDICAL CARE STANDARD FORM 600 (EF) DATESYMPTOMS, DIAGNOSIS, TREATMENT, TREATING ORGANIZATION (Sign each entry)Provider:Date:Time:B/P:Pulse:Resp:Temp:Ht:Wt:Age:Tobacco: YES NOLMP:Last Pap:Tetanus:Allergies:Meds:Tech: STANDARD FORM 600 BACK (REV. 5-84) (EF-V1) 345p+,-2st{   &':FGL34ɿɵɩɤɤɤɤɤɤɤɤɤɤɤɤɤɤɤCJEHCJEH EHOJQJ5CJEHOJQJ5CJEHOJQJ CJOJQJ EHOJQJ6CJEHOJQJCJEHOJQJOJQJ 5OJQJ5CJOJQJEH@45:8`T1$$THH    0*$-D-$$l    0*-$$l    0*    $$-D$ 45:,-2st{   &'0:FGL3456789:;RSTUVWXY_`a       [,-2st{d  0$-D # f6 vF$-D1$$THH    0*$$-D # f6 vF   &'0:FGLph,1$$THH    0*$-D # f6 vF$-D3456789:h4  d$-D1$$THH    0*$-D # f6 vF456789:;RSTUVWXY_`az  !01>?@PQhvwû˯˯x5CJH*OJQJ5CJEHH*OJQJ5CJEHOJQJ5CJEHOJQJ56CJEHH*OJQJ5CJEHH*OJQJ5CJOJQJ5CJOJQJOJQJ6CJEHOJQJ6CJEHOJQJCJEHOJQJ EHOJQJCJEH CJOJQJ/:;RSTUVWXY_` /$$TH    0%*1$$THH    0*$-D # f6 vF$-D `al$:$$l    F*$$-D$$-D/$$TH    0%*      !01>Ƹz|C$$l    \ $*$$-D8$$l    F$*    !01>?@PQhvw: ; E F G M N O U V W \ ] ^ e f g m n o u v w { | }       ^>?@PQhvw: zvvvoo$$-D-DC$$l    \$*   $$-D8$$l    F'!* wy{( 9 E F G M N O U V W \ ] ^ e f g m n o u v w { | } CJOJQJCJ6CJOJQJ CJOJQJOJQJCJH*OJQJ CJOJQJS: ; E F G M N O U V W \ ] ^ e f g m n 0 $ /$$HH    0*$-D-$$l    0*n o u v w { | } T0,$-D/$$HH    0* 4 /$$HH    0*$-D $-D/$$HH    0* 5    . 3 4 5 6CJOJQJ CJOJQJOJQJ CJOJQJCJ 5 -D/$$HH    0*  $-D/ =!"#$%/ =!"#$% [(@(NormalCJmH F@F Heading 1 $-D@&5CJEHH*OJQJH@H Heading 2$$-D@&5CJEHOJQJ<A@<Default Paragraph Font>B@> Body Text $-D5CJOJQJ5664w 5  :`>: n 5   5 -2;Cgk7;D7 US Air ForceP\\FS168A\APPS\USERS\COMMON\Clinical Templates\SF600 Overprints\UTI overprint.dot US Air Force.C:\TEMP\AutoRecovery save of UTI overprint.asd US Air Force.C:\TEMP\AutoRecovery save of UTI overprint.asd@;;;;5@@GTimes New Roman5Symbol3& Arial"qh"+&y31f*+ Y20dH HEALTH RECORD US Air Force US Air ForceOh+'0   < H T `lt|HEALTH RECORDoEAL US Air ForceoS AUTI overprint.dotd US Air Force.do7 AMicrosoft Word 8.0@xA@@~@^N|9՜.+,D՜.+,< hp  USAFR H HEALTH RECORD Title 6> _PID_GUIDAN{F7228887-6E45-11D2-B777-00E029028A6E}  !"#%&'()*+-./01236Root Entry F19981TableWordDocument<6SummaryInformation($DocumentSummaryInformation8,CompObjjObjectPool99  FMicrosoft Word Document MSWordDocWord.Document.89q