General & Administrative
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PHYSICAL EXAM:

- GENERAL: Alert and oriented x 3. No acute distress. Well-nourished.

- EYES: EOMI. Anicteric.


- HENT: Moist mucous membranes. No scleral icterus. No cervical lymphadenopathy.


- LUNGS: Clear to auscultation bilaterally. No accessory muscle use.


- CARDIOVASCULAR: Regular rate and rhythm. No murmur. No JVD.


- ABDOMEN: Soft, non-tender and non-distended. No palpable masses.


- EXTREMITIES: No edema. Non-tender.
SKIN: No rashes or lesions. Warm.

- NEUROLOGIC: No focal neurological deficits. CN II-XII grossly intact, but not individually tested.


- PSYCHIATRIC: Cooperative. Appropriate mood and affect.
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ROS:

- CONSTITUTIONAL: Denies weight loss, fever and chills.

- HEENT: Denies changes in vision and hearing.

- 
RESPIRATORY: Denies SOB and cough.


- CV: Denies palpitations and CP. 


- GI: Denies abdominal pain, nausea, vomiting and diarrhea.


- GU: Denies dysuria and urinary frequency.


- MSK: Denies myalgia and joint pain.


- SKIN: Denies rash and pruritus.

- 
NEUROLOGICAL: Denies headache and syncope.


- PSYCHIATRIC: Denies recent changes in mood. Denies anxiety and depression.
PHYSICAL EXAM:

- GENERAL: Alert and oriented x 3. No acute distress. Well-nourished.

- EYES: EOMI. Anicteric.


- HENT: Moist mucous membranes. No scleral icterus. No cervical lymphadenopathy.


- LUNGS: Clear to auscultation bilaterally. No accessory muscle use.


- CARDIOVASCULAR: Regular rate and rhythm. No murmur. No JVD.


- ABDOMEN: Soft, non-tender and non-distended. No palpable masses.


- EXTREMITIES: No edema. Non-tender.
SKIN: No rashes or lesions. Warm.

- NEUROLOGIC: No focal neurological deficits. CN II-XII grossly intact, but not individually tested.


- PSYCHIATRIC: Cooperative. Appropriate mood and affect.
-----------------------------------------------------------------
ROS:

- CONSTITUTIONAL: Denies weight loss, fever and chills.

- HEENT: Denies changes in vision and hearing.

- 
RESPIRATORY: Denies SOB and cough.


- CV: Denies palpitations and CP. 


- GI: Denies abdominal pain, nausea, vomiting and diarrhea.


- GU: Denies dysuria and urinary frequency.


- MSK: Denies myalgia and joint pain.


- SKIN: Denies rash and pruritus.

- 
NEUROLOGICAL: Denies headache and syncope.


- PSYCHIATRIC: Denies recent changes in mood. Denies anxiety and depression.

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