IDENTIFICATION

• Name
• Age
• Address
• Occupation

CHIEF COMPLAINTS

• Ulcer / growth in oral cavity

HISTORY OF PRESENT ILLNESS

• Duration
• Onset
• Progress
• Associated Pain
• H/o Excessive Salivation (due to irritation)
• H/o Dysphagia (e.g., ca of post. 1/3 of tongue)
• H/o Dysarthria
• H/o Trismus (infiltration of masseter & pterygoid)
• H/o Discharge / Bleeding
• H/o Loosening of Tooth