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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

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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

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