Name

Age

Sex

Occupation

Residence

Marital status

Date of admission

C/o 

Haematouria for 1 month

History of Present Illness

Haematuria :Onset , Duration Number of times, Volor ,Relation to urinary stream, containing blood clots , The effect on the pt .Hospitalizations .Time of stop spontaneously or by intervention.

Lower urinary symptoms 

○ Urine   :Amount  -Color.

Irritative 

Suprapubic pain old car

Urgency

Increase frequency

Incontinence

Nocturia

Eneuresis

Strangary

Obstructive 

Straining

 Urine retention

Histancy

Weak stream

Pifid stream

Post voiding dripping

Sense of incomplete emptying

Upper Urinary Symptoms 

Loin pain

Mass

Fever

Symptoms of Malignancy

Wt loss .symptoms of anemia. Fever with sweating .

Symptoms of mets

GIT : jaundice. abdominal distension.

CVS+ Respiratory :cough with haemoptysis chest pain lower limb oedema.

CNS :loss of consciousness . Headache . Convulsion .

FILL THE GAB 

Past Medical History 

Hospitalizations

Surgical operation

Blood transfusion

Cystoscopy

VIU

Dilation

Penile discharge gonorrhoea

Prostatic biopsy

Schistosomiasis

Family History

Similar conditions

Malignancies

Drug History

BPH drugs

Chemo radiation

Social History

Education

Job

Health insurance

Smoking  

Alcohol abuse

IPSS Score