C09993523 / invoice 10000

Reason: 4th Synovan Tw Appointment Notes: Overdue remindersAttendees:History:Eating drinking urinating defaecating normallyNo vomiting/retchingNo coughing, no exercise intolerance, no breathing difficultyNo yelpingMuch more comfortable when trying to get up onto furnitureNo itching and scratchingBright Alert ResponsiveBody condition scoreExamination:Mucous membranes – pink moist crt <2sOral cavity – clear, no evidence of ulceration, tongue normal, hard palate fineTeeth – grade 0Nasal planum – normal pigmentation and architecture, no crusting, no dischargeEyes – eyelid conformation normal, PLR normal, no chemosis,  no dischargeEars – no discharge, no erythema, pinna fineLymph nodes - normalHeart – normal regular rhythm no pulse deficits, no murmur HR 100Lungs – clear sounds bilaterally, no crackles or wheeze, tracheal pinch negativeAbdomen – comfortable on palpation, bladder normal, no masses palpatedLimbs – better range of motion in hips than previously. Neck and spine – no pain on palpationSkin – no sign of erythema, no alopecia,  Nails – fineAnal glands – not performedTemperature – not performedGenital region - no masses or swellingsDiagnosis:1. Fit for synovanTreatment:1. SYnovan 0.63ml SQ 2. Repeat in 4 weeks    Vital Signs