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Initial Evaluation

The patient is a 46-year-old, 120-pound, left-handed Filipino man from Antipolo City who was referred by his doctor for an initial evaluation. He is married, works as an occupation, and practices Roman Catholicism. His general information was collected as part of an initial evaluation.

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24 views

Initial Evaluation

The patient is a 46-year-old, 120-pound, left-handed Filipino man from Antipolo City who was referred by his doctor for an initial evaluation. He is married, works as an occupation, and practices Roman Catholicism. His general information was collected as part of an initial evaluation.

Uploaded by

butowski
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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INITIAL EVALUATION

General Information

Patients name: D. X.QWS

Age: 46 y/o

Gender: Male

Weight: 120lbs

Address: Antipolo City

Handedness: Right/LEFT

Civil Status: Married

Occupation:

Religion: Roman Catholic

Nationality: Filipino

Referring unit:

Rehab MD: Referring MD:

Date of consultation:

Date of referral:

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