case performa

1. Case Recording Performa
MEDICINE CLINIC-II
University College of Veterinary & Animal Sciences
Date:_____________
Introduction of Owner:
Name of Owner:__________________ Father Name:__________________
Address: ______________________ Contact No.: ___________________
Description of Animal:
 Specie: _____________ Breed:______________
 Sex:________________ Age:________________
 Color:______________
History:______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Clinical:______________________________________________________________________
_____________________________________________________________________________
Physical Examination:
Temperature:______________ Pulse:___________________
Respiration:_______________ Palpation:_______________
Aspiration:________________
Differential
Diagnosis:_____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
___________________________________________________________________________
Tentative Diagnosis:____________________________________________________________
Treatment:____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________________________
_______________________
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