{literal} {/literal}
Review Of Systems
Review of Systems
Enter only positive symptoms patient has had in last 2 weeks.
Health
When was your last tetnus shot?:
When was your last Pneumonia shot?:
When was your last Flu shot?:
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{if !is_numeric($row_title)}
{$row_title}
{html_checkboxes name="checks" options=$row selected=$review_of_systems->checks separator="
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{if $row_title eq "Women"}
Date of last Pap Smear:
Date of last Mammogram:
Date of last Bone Density Scan:
Have you ever had an abnormal Pap Smear:
Have you ever had an abnormal Mammogram:
{elseif $row_title eq "Men"}
Date of Last PSA:
{elseif $row_title eq "When sexually active,
are you active with:"}
How many packs of cigarettes do you smoke per day:
How many years have you smoked:
How much alcohol do you drink a week:
If you use recreational drugs, please give us a list:
{/if} {else}
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{/if}
{/foreach} {/foreach} {if $VIEW != true}
[Don't Save]
{/if}