annonsbokning-test-11_01

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ANNONSBOKNING SYMPTOMS, CLINICAL COURSE, PAST MEDICAL HISTORY AND SOCIAL HISTORY Name

During this illness, did the patient experience any of the following symptoms? Fever > 100.4F (38C)

Yes

No

Unknown

Subjective fever (felt feverish)

Yes

No

Unknown

Chills

Yes

No

Unknown

Muscle aches (myalgia)

Yes

No

Unknown

Runny nose (rhinorrhea)

Yes

No

Unknown

Sore throat

Yes

No

Unknown

Cough

Yes

No

Unknown

During this illness, did the patient experience any of the following symptoms? Fever > 100.4F (38C)

Yes

No

Unknown

Subjective fever (felt feverish)

Yes

No

Unknown

Chills

Yes

No

Unknown

Muscle aches (myalgia)

Yes

No

Unknown

Runny nose (rhinorrhea)

Yes

No

Unknown

Sore throat

Yes

No

Unknown

Cough

Yes

No

Unknown

During this illness, did the patient experience any of the following symptoms? Fever > 100.4F (38C)

Yes

No

Unknown

Subjective fever (felt feverish)

Yes

No

Unknown

Chills

Yes

No

Unknown

Muscle aches (myalgia)

Yes

No

Unknown

Runny nose (rhinorrhea)

Yes

No

Unknown

Sore throat

Yes

No

Unknown

Cough

Yes

No

Unknown


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