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Summary Medical Clerking Template

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This simple clerking template will make sure you take a full and comprehensive history without the stress of worrying if you forgot something!

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Uploaded on
June 27, 2023
Number of pages
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Written in
2022/2023
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Summary

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LBRRY.cr
Patient History & Examination
NAME D.O.B/SEX MRN ADMISSION DATE CURR




PRESENTING COMPLAINT PAIN

Main symptom/s: Site

Onset

Referral from: self, GP, clinic, other Character

Radiation

History leading to this complaint & Systemic enquiry: Associations

Timing

Exacerbation/alleviation

Severity

PAST MEDICAL HISTORY MEDICATION
Medical/psychiatric:
Drug

Indication

Dose

Frequency
Surgical:
Side effects

Allergies

Compliance
SOCIAL & FAMILY HISTORY

Smoking Alcohol Recreational drugs OTHER
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LBRRYcreations

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LBRRYcreations St Georges (University of London)
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