1 Year WCC

Patient is a [text] Month Old [select value= "Select|M|F"] that presents to clinic for a well child check. 
Parental concerns: [textarea default= "Post Partum Depresion: Interval History:"]. 
Motor Milestones: [checklist value= "Pulls to stand|Cruises|Pincer grasp"][text]
Social/Language Milestone: [checklist value= "Plays games|Puts object in container|Waves bye|Says Mama/Dada"]
Sleep/Naps: sleeps [text] hours at night and naps [text]. Patient sleeps [textarea default= "location, put to sleep with bottle?Pacifier?"]
Food: 
[textarea default= "Frequency of meals, Picky Eater"]
Dental:
[checkbox value= "Brush teeth twice    daily|Fluoride given today"]
Child care:
[checkbox value= "Daycare|Home|Both daycare and home"]
Home: 
[textarea default= "Who lives at home: Siblings: Parents occupation:"]
Safety: [checklist value= "Cleaning supplies and medications stored in a safe place|Outlet  covers|Baby gates on stairs|Rear facing car seat if not at height/weight limit"][text]
[textarea default="Meds: Allergies: PMH: PSH: FH:"]
Parental Education: Reading to child daily and avoiding use of screens. Dentist?
[comment memo="PE: **Red reflex,    HGB/Lead    level"]
[comment memo="4th    dose    PCV.    1st    dose    MMR/Varicella.    HepA?"]