personal history ? 7 marital history ? 8 menstrual history ? 9 childbearing history ? 10 family historyР1 General Data ?Name Native place ?Sex Working unit ?Age Date of admission ?Race Date of record ?Occupation Narrator ?Marriage Reliability ?AddressР2 plaints ?The plaints should constitute in a few simple words: symptom(s) plus time. The main reasons why the patient consults a doctor. ?The plaints should be stated as nearly as possible in the patient’s own words.РFor example: ?▲sore throat, high fever for ? two days ?▲chill, fever, right chest pain, ? cough for three days?▲recurrent epigastric pain for ? eight years, it has been getting ? worse over the past two weeks.РThe plaint should not include diagnostic terms ? or disease entities ?such as: ? diabetes ? heart disease ? hypertension
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