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Health History

1. Biographical Data

Date: 10/03/05
Examiner:

Name: . Phone:

Address:

Birth date: Birth place:

Age: 19 Sex: M Marital Status: Single Occupation: Student

Race/ethnic origin: Caucasian Employer: N/A

Health Insurance: None

2. Source and Reliability: Client himself, Seems reliable

3. Reason for Seeking Care: "Nausea, Upset stomach" Getting in the way of patients normal activity. Patient has had pain for up to 3 days now.

4. Present Health or History of Present Illness: Notices it more when he eats something. Noticed it first when he just got done eating, about 3 days ago. Not eating makes is better. And sleeping makes the patient feel better.
The severity of the pain on a scale of 1-10, patient rated it a 7.
Pain exists in the stomach, does not spread just hurts in the stomach. Pain has stayed the same for 3 days.
First noticed it after lunch 3 days ago. Patient has pain all the time but it gets worse after the......

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Approximate Word Count: 1210
Approximate Pages: 5 (250 words per double-spaced page)

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