FAMILY & COMMUNITY MEDICINE/RADIOLOGY ELECTIVE LOGBOOK

Student Name:

Class:
Elective:

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Elective End Week:
Age:

Patient's Gender:
Type of Problem:

Location: 
Chief Complaint:
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Diagnosis:
Diagnosis 2:
Diagnosis 3:

Type of Visit: 
Procedure:
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Problem List: 

Notes/Comments: 

 

 Contact us: Harald Lausen, DO (Curriculum Information)
 Jean Afflerbach (Web Master)

Page last updated Thursday September 06, 2012