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Get NJ VHM 23-02-001A 2012

E: Age Sex HT WT Middle Initial: Temp. Pulse Today’s Date: Resp. Vision: R 20/____ L 20/____ Pupils: Equal___ Unequal___ Glasses/Lenses: Y / N PHYSICAL EXAM NORMAL ABNORMAL B/P Job Title: Drug/Food Allergies Hearing:  Normal  Impaired  Hearing Aid COMMENTS 1. General Appearance / BMI 2. Skin 3. HEENT 4. Teeth 5. Neck 6. Lungs 7. Heart 8. Abdomen 9. GU System 10. Musculoskeletal Functioning (Full ROM to all extremities? History of injury to knees or hips?) 11. Back /.

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