Epstein Secrets

essure (I) Normal=N; Abnormal=A N A COMMENT: Abnormal Findings, by number 1. Appearance 2. Skin/Nose 3. Head/Scalp 4. Eyes 5. Visual Acuity (R & L) R Aro& °row 6. Ears 7. Auditory Acuity (11 Et L) 8. Nose / Throat 1 9. Mouth. Teeth and Gums 10. Chest / Lungs 11. Heart 12. Abdomen V 1

doses of DTP. DT (pediatric) is acceptable if Pertussis vaccine is medically contraindicated. (Complete Part C for Pertussis contraindication.) 4 Td (Adult) Vaccine is recommended for children 7 years of age or older. s Polio 4 doses required. If the third dose is administered on or after the fourth birthday. a

e (✓) Normal=N; Abnormal=A N A COMMENT: Abnormal Findings, by number 1. Appearance 2. Skin/Nose 3. Head/Scalp 4. Eyes • . 5. Mural Acuity (R & L) . 6. Ears Ii. 7. Ati0ttory Acuity1R & L) — 8. Nose / Throat 9. Mouth, Teeth and Gums 10. Chest / Lungs 1 i. Heart - 12. Abdomen 13. Geni

doses of DTP. 3 DT (pediatric) is acceptable if Pertussis vaccine is medically contraindicated. (Complete Part C for Pertussis contraindication.) Td (Adult) Vaccine is recommended for children 7 years of age orolder. $ Polio 4 doses required. If the third dose is administered on or after the fourth birthday, a

dings, by number 1. Appearance C < r. 2. Skin/Nose ../ 3. Head/Scalp / 4. Eyes 5. Visual Acuity IR & Ll . / 6. Ears / 7. Auditory Acuity (R & L) / 8. Nose / Throat / 9. Mouth. Teeth and Gums /,.." 10. Chest / Lungs / 11. Heart / 12. Abdomen / 4". 13. Genitals and Anus / 14. Musc

es of DTP. 3 DT (pediatric) is acceptable if Pertussis vaccine is medically contraindicated. (Complete Part C for Pertussis contraindication.) 4 Td (Adult) Vaccine is recommended for children 7 years of age or older. Polio 4 doses required. If the third dose is administered on or after the fourth birthday, a fo