Past History

Similar condition in the past
episodes
Seeking healthcare before
Investigations done
Received management
Diagnoses
Ago
times
Following up anywhere
Surgery/Procedures
Ago

If patient cannot determine the surgery/Procedure specify

Usage of health equipment
Allergy
Blood transfusion
Ago
History of injury/burn/poisoning
Ago
Burn
Radiation
Immobilization
Travel
Ago