Mary Joseph

  
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 2023 Mar 26 at 3:41:29 PM EDT 
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 2023 Mar 26 12:37:28 PM PAGE  
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 DOD Salinas - Abbott 
 James Bush 
 558 Abbott St Ste A 
 MRN: 3111xxx, DOB: 1994 Jan 28, Sex: F 
 DOCTORS 
 Salinas CA 
 Visit date: 2023 Oct 26
 ON DUTY 

 HIM ROI Letters Report 
 
 Review of Systems 
 Constitutional: Negative for chills and fever. 
 Respiratory: Negative for shortness of breath. 
 Cardiovascular: Negative for chest pain. 
 Gastrointestinal: Negative for abdominal pain.
 Musculoskeletal: Positive for arthralgies, back pain.
 stiffness. 
 Physical Exam 
 Vitals reviewed. 
 Constitutional: 
 Appearance: Normal appearance. 
 HENT: 
 Head: Normocephalic and atraumatic. 
 Eyes: 
 Conjunctiva/sclera: Conjunctivae normal. 
 Effort: Pulmonary effort is normal. 
 Breath sounds: Normal breath sounds. 
 Musculoskeletal: 
 General: No swelling or deformity. Tenderness: Normal range of motion. 
 Right knee: No effusion
 Instability Tests: Anterior drawer test negative.
 Left knee: No effusion or bony tenderness.
 Instability Tests: Anterior drawer test negative.
 Right lower leg: No edema. 
 Left lower leg: No edema. 
 Comments: L knee: + Thessaley test
 Skin: 
 General: Skin is warm and dry. 
 Neurological: 
 Mental Status: She is alert. 
 Generated on 2021 Jul 01 12:34 PM 
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