"MedcinForm-V1.0"
"L&DENC--OB--NHTP--RLE--OPTION 1","Navy Forms","System"
0,0,0,830,535,0,1048576,"","",""
2,5,377,295,295,0,32," |||||||0|0||0|0|||0|||0|0|0|0|0||||","V=1:DF=0:PS=1:TP=0:MR=F:BS=0:TWS=0:PB=0:NB=1:ROS=0:PL=0:FB=0:EM=0:CB=2",":-2147483633:HPI / PMH / ROS|PE / Tests"
1,20,20,810,40,1718,33562881," |||||||19|660|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","The Chief Complaint is:"
1,20,420,390,440,1408,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","C=1520097|B=T|T=T|L=","Violent Behavior - Spouse Beating"
1,20,190,810,260,112342,4203265," |||||||19|540|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Other HPI"
1,10,290,400,390,0,2," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|F=Arial Black|L=5:","0:0:1:1:PMH"
1,20,170,810,190,112226,33563393," |||||||19|540|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Baby (in uterus) Daily Movements Counted~>10/hr."
1,20,110,810,130,1622,33563393," |||||||19|540|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Bleeding During Pregnancy"
1,20,90,810,110,111304,33563393," |||||||19|540|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Labor Pains~contractions every ___ minutes."
1,20,130,810,150,111308,33563393," |||||||19|540|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Her Water Broke"
1,20,150,810,170,610,33563393," |||||||19|540|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Vaginal Discharge (other than menstruation)"
1,20,300,390,320,30601,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Preeclampsia"
1,20,320,390,340,236570,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Preterm Labor"
1,20,340,390,360,5349,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","History of the ____ Pregnancy:"
1,20,360,390,380,122300,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Past Medical/Surgical History [other]"
1,440,300,810,320,10,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Headache"
1,440,320,810,340,105,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Blind Spots (scotoma)"
1,440,340,810,360,475,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Abdominal Pain"
1,440,360,810,380,526,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Pain During Urination (dysuria)"
1,440,380,810,400,281139,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Urinary Frequency"
1,440,400,810,420,550,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Feelings of Urinary Urgency"
1,440,420,810,440,558,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Pain in the Flank"
1,440,440,810,460,1113,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Itching (pruritus)"
1,440,460,810,480,1089,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Skin Lesions"
1,440,480,810,500,363,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Soft Tissue Swelling (non-joint)"
1,20,450,390,510,116473,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","C=1520097|F=Microsoft Sans Serif|B=T|T=T|L=","Do you now, or have you ever felt in fear for your safety in your environment?  If yes explain and ensure a FAP and perinatal social worker consult have been generated.~now, or ever, felt for your safety in your environment."
0,420,5,825,530,0,4,"","I=FS=FB=T",""
1,10,60,820,270,0,2," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|F=Arial Black|L=1:","0:0:1:1:HPI"
1,10,410,400,520,0,2," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|F=Arial Black|L=2:","0:0:1:1:Safety   "
1,430,290,820,520,0,2," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|F=Arial Black|L=3:","0:0:1:1:ROS"
1,10,10,820,50,0,2," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|F=Arial Black|L=4:","0:0:1:1:Chief Complaint       "
2,50,350,184,370,222945,76033," ||||||cm|19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:RUQ"
2,430,50,820,70,260409,33563393," ||||||cm|19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Cervical Dilation (cm)"
2,430,70,820,90,263043,33563393," ||||||%|19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Effacement (%)"
2,430,30,600,50,0,32769," |||||||0|80||0|0|||0|||0|0|0|0|0||||","|B=T","Cervical Findings:"
2,430,110,820,130,263061,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Cervix Consistency"
2,430,190,820,210,263065,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Cervix Position In Vagina"
2,430,90,820,110,290296,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Station (- To +)"
2,470,130,820,150,263062,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Soft"
2,470,150,820,170,263063,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Medium"
2,470,170,820,190,263064,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Firm"
2,470,210,820,230,263066,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Posterior"
2,470,230,820,250,263067,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Mid"
2,470,250,820,270,263068,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Anterior"
2,10,30,410,50,195992,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Current Vital Signs Reviewed"
2,10,50,410,70,9307,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|T=T|L=","General Appearance Normal"
2,10,70,410,90,7041,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|T=T|L=","Lungs Clear to Auscultation"
2,10,90,410,110,206245,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|T=T|L=","Heart Rate And Rhythm were Normal"
2,10,110,410,130,7180,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","A Murmur was Heard"
2,10,130,410,150,7268,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Edema was Present"
2,10,150,410,170,7358,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|T=T|L=","Abdomen was Normal"
2,10,170,410,190,7523,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|T=T|L=","Genitalia was Normal"
2,10,190,410,210,60792,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Antenatal Fetal Position (___ weeks)"
2,10,210,410,230,60835,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Fetal Heart Rate ___ bpm"
2,10,230,410,250,206292,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Fetal Heart Sounds (Doppler)"
2,430,300,820,320,183400,33563393," |||||||19|230|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","NST Reactive?"
2,10,250,410,270,260410,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Contractions~every __ minutes."
2,10,270,410,290,208847,33563393," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Other Physical Findings"
2,10,330,820,350,222944,33563393," |||||||19|590|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|B=T|T=T|L=","Amniotic Fluid Index - Normal"
2,10,380,820,400,222943,33563393," |||||||19|590|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Fetal Biophysical Profile"
2,10,300,410,320,19290,33562881," |||||||19|180|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Fetal Non-Stress Test~baseline ___bpm."
2,10,430,820,450,19287,33562881," |||||||19|490|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Contraction Stress (specify positive or negative)"
2,10,450,820,470,18326,33563393," |||||||19|490|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|B=T|T=T|L=","Amniocentesis was Normal (if abnormal, specify)"
2,50,400,162,420,222950,76033," |||||||19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:Tone"
2,210,400,342,420,222951,76033," |||||||19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:Breathing"
2,10,470,820,490,17305,33563393," |||||||19|490|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|B=T|T=T|L=","Vaginal Wet Mount Smear was Negative"
2,10,490,820,510,17309,33563393," |||||||19|490|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|B=T|T=T|L=","Vaginal KOH Prep was Negative"
2,10,510,820,530,220255,33562881," |||||||19|680|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Tests [Other]~Nitrazine  Pos [   ]  Neg [   ]    |    Pooling  Pos [   ]  Neg [   ]    |    Valsalva  Pos [   ]   Neg [   ]    |    Ferning  Pos [   ]   Neg [   ]"
2,10,10,310,30,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|B=T|I=T","Please describe abnormal findings"
2,368,350,500,370,222946,76033," ||||||cm|19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:LUQ"
1,20,70,270,90,4415,33562880," |||||||19|230||0|0|||0|||0|0|0|0|0||||","|T=T|L=","~Estimated Gestational Age: "
2,529,350,659,370,222947,76033," ||||||cm|19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:LLQ"
2,210,350,342,370,222948,76033," ||||||cm|19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:RLQ"
2,686,350,820,370,222949,76033," ||||||cm|19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:Total"
2,368,400,505,420,222952,76033," |||||||19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:Movement"
2,529,400,695,420,222953,76033," |||||||19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|L=",":0:0:0:2x2 Fluid Pocket"