Patient data
Patient ID 99990000999 Name Physician 2 name Sex Male DOB Oct. 12, 1988

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S: Suffering 38C fever since one week ago
Recorded by Physician 2 name @ Facility Test Clinic 2[JPN999999900099]
Date recorded 01-25-2002 @ Department medicine [01]
FreeExpression

S: 38C fever appeared one week ago. OTC cold medication taken to no effect. Accompanied by strong headache, nausea, and vomiting from 2 days ago. Symptoms were worse this morning, prompting patient to seek examination.
O: Awareness normal
BT: 39.5C, BP: 150/100 mmHg
Auscultation of chest showed high pulse of 110. No other findings.
Patient has stiff neck.
- GOT
- GPT
- HDL-Ch
- K
- LDH
- ALP
- Na and Cl
- g-GTP
- BUN
- BIL, total
- Glucose
- Creatinine
- ChE
- Tcho
- CPK
- TP
- Protein fractionation
- UA
- Standard peripheral blood
- CRP
Injection
- IV drip
- Glucose injection, 5% 250 ml, 1 bag
- Firstcin IV drip, 1 bottle
RP
- Ciproxan tablets 100 mg, 3 tablets
Take orally 3 times/day after meals for 5 days
Outside prescription
RP
- Voltaren SR capsules, 37.5 mg, 2 capsules
Take orally, two times/day after morning and evening meals for 5 days
Outside prescription