GU INFECTION
Date	Name	DOB/Age
Allergies	LMP
S	Duration	Dysuria frequency urgency hematuria incomplete emptying fever ABD pain flank pain pelvic pain
nausea/vomiting dysparenunia	OTHER
VAGINAL/URETHRAL	Discharge discomfort puritus bumps sores blisters	WET MOUNT
O	VITALS	BP	P	T	Weight	Urine PG	UA
A
P
RX
UC	VAG/URETHRAL CULTURE	GC/CHLAMYDIA	HSV	IVP
Partner RX	Back-up contraceptive

GU INFECTION
Date
Name	DOB/Age
Allergies	LMP
S	Duration	Dysuria frequency urgency hematuria incomplete emptying fever ABD pain flank pain pelvic pain
nausea/vomiting dysparenunia	OTHER
VAGINAL/URETHRAL	Discharge discomfort puritus bumps sores blisters	WET MOUNT
O	VITALS	BP	P	T	Weight	Urine PG	UA
A
P
RX
UC	VAG/URETHRAL CULTURE	GC/CHLAMYDIA	HSV	IVP
Partner RX	Back-up contraceptive

2003-12-26

Microsoft Corporation