PHYSICAL EXAM TEMPLATE FORMAT # 1: PHYSICAL EXAMINATION: GENERAL APPEARANCE: The patient is alert, oriented and has a bandage

over his left eye. He is in no acute distress. VITAL SIGNS: T-max was 100, currently 97.5, blood pressure 110/60, respirations 22, and heart rate 88. HEENT: Head is normocephalic. He does have an area of purpura over his left periorbital area. There is also a small laceration over his forehead. The sinuses are otherwise nontender. Pupils are equal and reactive. The nares are patent. Oropharynx reveals poor dentition but is clear without lesions. NECK: Supple without lymphadenopathy. HEART: Regular rate and rhythm. LUNGS: Revealed decreased breath sounds at the bases. No crackles or wheezes are heard. ABDOMEN: Soft, nontender, nondistended with good bowel sounds heard. Inguinal area is normal. EXTREMITIES: Without cyanosis, clubbing or edema. NEUROLOGICAL: Gross nonfocal. Skin: Warm and dry without any rash. There is no costovertebral angle tenderness.

PE TEMPLATE FORMAT # 2:

PHYSICAL EXAMINATION: GENERAL APPEARANCE: The patient is alert and oriented and in no acute distress. VITALS SIGNS: Temperature 98.4, pulse 72, respirations 20, and blood pressure is 118/76. HEENT: Head is normocephalic with normal hair distribution. No evidence of trauma. Ears: No acute purulent discharge. Eyes: Conjunctivae pink with no scleral jaundice. Nose: Normal mucosa and septum. NECK: Supple with no cervical or supraclavicular lymphadenopathy. Trachea is midline. Thyroid: Not palpable. LUNGS: Normal symmetrical expansion of both hemithoraces. Coarse breath sounds with some rhonchi. HEART: S1 and S2 normal. ABDOMEN: Soft. EXTREMITIES: No swelling or effusion in any of the joints of the hands or feet. No peripheral edema. SKIN: Normal color, turgor and temperature. No ulcerations or rashes noted. LYMPHATICS: No cervical or supraclavicular lymphadenopathy. NEUROLOGICAL: Cannot be assessed at this time since the patient is intubated and sedated.

PE TEMPLATE FORMAT # 3:

PHYSICAL EXAMINATION: General Appearance: This is a (XX)-year-old female, who answers questions appropriately and currently is in no apparent distress. Vital Signs: Her blood pressure is 142/74, heart rate is 72, respiratory rate is 22, saturation 98% on room air, currently afebrile, temperature 98.2. Skin: Warm and dry without exanthem. HEENT: Normocephalic and atraumatic. Pupils are equal, round and reactive to light. Extraocular movements are intact. Oral mucosa is moist. There is no obvious bleeding in the gum. Oropharynx is without erythema or exudate. Lungs: Breath sounds are clear bilaterally without rales, rhonchi or wheezing. Heart: No elevation of JVP. Heart is irregularly irregular with no appreciable gallops, rubs, murmurs or extra heart sounds. Abdomen: Soft, nontender, nondistended in all quadrants. No audible bowel sounds. No palpable masses. Peripheral Vascular: Radial and pedal pulses are 2/4 bilaterally. Extremities: Warm without clubbing, edema or cyanosis. Neurological: The patient is oriented to person, place and time. Strength and sensation are grossly intact. Face is symmetric.

PE TEMPLATE FORMAT # 4:

PHYSICAL EXAMINATION: GENERAL: The patient is a well-developed, well-nourished male in no apparent distress. He is alert and oriented x3. VITAL SIGNS: Temperature 98.4, pulse 72, respirations 18, blood pressure 146/78, and O2 saturation 96% on room air. HEENT: Head is normocephalic and atraumatic. Extraocular muscles are intact. Pupils are equal, round, and reactive to light and accommodation. Nares appeared normal. Mouth is well hydrated and without lesions. Mucous membranes are moist. Posterior pharynx clear of any exudate or lesions. NECK: Supple. No carotid bruits. No lymphadenopathy or thyromegaly. LUNGS: Clear to auscultation. HEART: Regular rate and rhythm without murmur. ABDOMEN: Soft, nontender, and nondistended. Positive bowel sounds. No hepatosplenomegaly was noted. EXTREMITIES: Without any cyanosis, clubbing, rash, lesions or edema. NEUROLOGIC: Cranial nerves II through XII are grossly intact. PSYCHIATRIC: Flat affect, but denies suicidal or homicidal ideations. SKIN: No ulceration or induration present