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Case Narrating Data-1of3

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Name*

Age*

Gender *

FemaleMale

Email*

Present complaint in detail*

( Sensation / physical character, location, extension, modalities, concomitant & Duration)

Other complaints
(Head ; eye & vision; Ears & Hearing; Nose & smell; Face & Mouth; teeth ; Throat ; Stomach; abdomen; rectum ; stool; Urinary Genitalia; Respiratory system; Chest; Back; Extremities & skin i.e. starting with the hair and ending with the nail).

History of present illness in chronological order
Mode of onset, probable cause, treatment already adopted and its results, any other special information

Past History
Past illness including operation (since childhood) - treatment done and result etc. history during pregnancy; birth history in case of children.

Family History
Health / Cause of death : Peternal Side, Maternal side; Brothers and sisters; any other significant history.