PAST HISTORY
- Rheumatic Fever
- Tuberculosis/ asthma
- Diabetes
- Jaundice
- Blood transfusion
- Mental illness
- Operations/ accident
Family History
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Diabetes
-
Hypertension
-
Heart disease
-
Malignancy
-
Cause of death
-Father/Mother/Siblings/Spouse/Children/Grand parents / Close relatives
HISTORY OF MEDICATIONS
-
Insulin
-
Steroids
-
NSAID
-
Contraceptive pills
-
Antibiotics
-
Others
Social History
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Marital status
-
Occupation
-
Travel abroad
-
Accommodation
-
Habits ( smoking, alcohol )
-
Dependent relatives
Psychiatric/ emotional background
Allergies
- Food
- Drugs
Immunizations
- Tetanus
- Diphtheria
- Tuberculosis
- Hepatitis
- Others