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| สภาพทั่วไป (GA) : |
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ซีด (Pale) : |
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เหลือง (Jaundice) : |
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| ต่อมน้ำเหลือง (Lymh node) : |
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| ต่อมน้ำเหลืองที่ไหปลาร้าซ้าย (Virchow node) : |
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ไม่มี (No) : |
มี (Yes) |
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ขนาด (Size) : |
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| ก้อนบริเวณ (Mass at) : |
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ขนาด (Size) : |
ซม.(cms./FB) |
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| บริเวณ (At) : |
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ขนาด (Size) : |
ซม.(cms./FB) |
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| บวมบริเวณ (Edema) : |
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| ศีรษะ (Head) : |
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หัวใจ (Heart) : |
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ปอด (Lung) : |
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| ช่องท้อง (Abdomen) : |
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| สภาพจิต (Mental status) : |
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