4 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= "head flops back|hands in fists moving in front of mouth/face|Tummy time"][text]
Social/Language Milestone: [checklist value= "eyes track you across the room|turns to sounds|smiles"]
[textarea default= "Sleep/Naps, put to sleep with bottle?Pacifier?"]
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 1mg/kg if only breast feeding/pre-me"]
Child care:
[checkbox value= "Daycare|Home|Both daycare and home"]
Dentist:
[checkbox value= "Teething|Cleaning mouth out with washcloth after meals|Scheduled dentist appointment|Looking to schedule dentist appointment"]
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: Reading to child daily and avoiding use of screens. Dentist?
[comment memo="PE: **Red reflex"]
[comment    memo="2nd    dose    Rotavirus/DTaP/HiB/IPV"]