 6. o Pro'-;de the doctor to whom the pa~e~t is be!ng referred to :-vith appropna. clinical record or referral note crmtammg a bnef history, physical examin. tc tinclings laboralorv results (if available) and managcm. ent started at the re~eut~on · · ',, rr11 level (See Figure 3 of Chapter 3 for a sample referral form). 1 g PLAN C: 1. 0 2. 0 5. 0 254 Refer the patient immediately to a hospita l (preferabl y the nearest one). Keep the patient calm. Make the patient lie do,,.,"Il quietly. If the patient has djfficulty of breathing, place ber in a semi-sitting position. her back well supported by pillows. 'v1 th P~o~de the hospital where the pati. ~~t is being r~ferred to with appro ri. chmcal record or refenal note contaming a bnef history, physical e.-... :am J ti ate findings, laboratory res U-lts (if available) and management started at the refe~ 00 level (See Figure 3. 2 of Chapter 3 for a sample referral fonn)..., tlg 