Doctor

2. FOLLOW—UP PATIENT EVALUATION Awoovsn EAR, NOSE 8: THROAT CENTER 198 MASSACHUSETTS
AVENUE NORTH ANOOVER, MA 01845 978.685.7550
Patient Name ' W DOBH ' Date /0 '0 No change from Last Visit: Med/Surg A , ROS A Meds A , Allergy A
CC/HCC: (Location, Quality, Severity, Duration, Timing, Modifying Factors, Associated Signs & Symptoms) (1 -3elements -)
Level 2, 4-8 -) Level 3,4,5)
Communication Mood & Affect Orientation EYES: EOMI PERLLA Nystamus Conjuctiva EARS
External Appearance EAC - Right
EAC — Left TM — Right TM — NOSE External Septum Turbinates
Mucosa
OC/OP Lips/Gums/Teeth Oral Mucosa/F OM
E
Pharynx Tongue/PalatefUvula Tonsil
Throat
Vocal Cords VC Mobility
Pyriform Sinus/Arytenoid Supraglottis
Head & Neck
Salivary Glands Thyroid
Trachea Nodes/Masses Other Resp/Neuro/CV: