Progress Note

Mrs. KATE ALLENA

Chart ID 11111D1

Age 69 Years

  • 07-23-1957 (66 years)
  • Male
  • +1-212-456-7890
  • ibeothpeter@gmail,com
  • Non-Dual Aged
  • ibeothpeter@gmail,com
  • 11-02-2023
  • 2.55
  • Medical Health Insurance
  • 14XE-YT78-8901

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Orientation
Score
Maximum
What is the (year) (season) (date) (day) (month)?
( )
5
Where are we (state) (country) (town) (hospital) (floor)?
( )
5
Registration
Name 3 objects: 1 second to say each. Then ask the patient all 3 after you have said them. Give 1 point for each correct answer. Then repeat them until he/she learns all 3. Count trials and record. Trials
( )
3
Attention and Calculation
Serial 7's. 1 point for each correct answer. Stop after 5 answers. Alternatively, spell "world" backward.
( )
5
Recall
Ask for the 3 objects repeated above. Give 1 point for each correct answer.
( )
3
Language
Name 2 common objects
( )
2
Repeat the following "No ifs, ands, or buts"
( )
1
Follow a 3-stage command: "Take a paper in your hand, fold it in half, and put it on the chair"
( )
3
Read and obey the following: CLOSE YOUR EYES
( )
1
Write a sentence.
( )
1
Copy the design shown.
( )
1
Total
( )
30