VITALS
Temp: 36.1, HR 79, BP 105/71, RR 12, Weight 104 lbs, Height 5’6
PHYSICAL EXAM
General appearance: Well appearing, interactive, non-toxic
HEENT: Dry mucous membranes, erythema at the oral commissures bilaterally, no oral lesions
Cardiac: Regular rate and rhythm
Respiratory: Breathing comfortably on room air
Abdominal: Prior surgical scar in place, well healed, no abdominal tenderness, no rebound/guarding
Extremities: Warm and well perfused, no edema
Neurological: AOx3, non focal neuro exam
Psych: Interactive, pleasant.
Relevant Labs:
Hg 9.7, MCV 104, Plt 416
CRP 1.8, ESR 23 Albumin: 3.9, Glucose 90
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