HISTORY

1. IDENTIFICATION

• Name
• Age
• Education
• Occupation
• Husband’s Name
• Address

2. CHIEF COMPLAINTS

• Bleeding P/V
• Pain
• Discharge
• Mass per abdomen

3. HISTORY OF PRESENT ILLNESS

• Duration
• Onset
• Progress

4. PRESENT MENSTRUAL HISTORY

• Age of menarche
• Cycles (Duration, Frequency, Regularity)