OTHER MEDICAL HISTORY AS INDICATED FOR PATIENT
Living conditions and exposure to environmental factors, including tobacco smoke
IDENTIFIED ISSUES
ACTION
Other history considered necessary by doctor or collector (including stressful life events)
IDENTIFIED ISSUES
ACTION
MEDICAL EXAMINATION
HEIGHT AND WEIGHT (plot and Interpret growth curve/calculate BMI)
IDENTIFIED ISSUES
ACTION
NEWBORN BABY CHECK – if not previously completed
(including red reflex check)
IDENTIFIED ISSUES
ACTION
TEETH AND GUMS
normal
abnormal
IDENTIFIED ISSUES
ACTION