2 Month WCC
Patient is a [text] Month Old [select value= "Select|M|F"] that presents to clinic for a well child check. [textarea default= "Post Partum Depression: Denies feelings of depression, anhedonia, SI/HI. Concerns:"]. Motor Milestones: [checklist value= "Holds head up briefly|Opens hands|Tummy time"][text] Social/Language Milestone: [checklist value= "eyes wander|turns to sounds|smiles"] [textarea default= "Sleep/Naps"] Food: [textarea default= "frequency of feeds, how much if bottle fed, time spent eating, Vitamin D drops for breast fed infants 400 IUs daily, Iron supplement for Pre-me 1mg/kg daily"] Child care: [textarea default= "When are you going back to work, child care?"] Home: [textarea default= "Who lives at home: Siblings: Parents occupation:"] Safety: [checklist value= "Put to sleep on back|No blankets, pillows or toys in crib|Firm mattress|Rear facing car seat|Never left unattended on raised surfaces"][text] [textarea default="Meds: Allergies: PMH: PSH: FH:"] Parental Education: Discussed importance of reading books and avoidance of screens. [text] [comment memo="PE: **Red reflex"] [comment memo="Immunizations: 2nd dose HepB, 1st dose:RSV/DTaP/HiB/PCV20/Polio(IPV)"]
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Sandbox Metrics: Structured Data Index 0.29, 16 form elements, 35 boilerplate words, 4 text boxes, 6 text areas, 3 check lists, 1 drop downs, 2 comments, 22 total clicks
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