Examinee Name
Jane Doe
HISTORY : Describe the history you just obtained from this patient. Include only information (pertinent positives and negatives) relevant to this patient's problem(s)
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Characters: /950
PHYSICAL EXAMINATION : Describe any positive and negative findings relevant to this patient's problem(s). Be careful to include only those parts of examination you performed in this encounter
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Characters: /950
DATA INTERPRETATION : Based on what you have learned from the history and the physical examination, list up to 3 diagnoses that might explain this patient's complaint(s). List your diagnoses from most to
least likely. For some cases, fewer than 3 diagnoses will be appropriate. Then, enter the positive or negative findings from the history and the physical examination (if present) that support each diagnosis. Lastly,
list initial diagnostic studies (if any) you would order for each listed diagnosis (e.g. restricted physical exam maneuvers, laboratory tests, imaging, ECG, etc)