History

1. IDENTIFICATION

• Name
• Age
• Address
• Occupation

2. CHIEF COMPLAINTS

1. Abdomen pain
2. Abdomen distension
3. Abdomen lump
4. Dysphagia
5. Vomiting
6. Hematemesis
7. Diarrhoea
8. Malena or Bleeding P/R
9. Jaundice
10. Fever
11. Oedema
12. Oliguria
13. Burning sensation