Patient Information
Name
Age
Sex
Male
Female
Other
Date
Chief Complaint / Presenting Problem
Vital Signs
Blood Pressure
Heart Rate
Respiratory Rate
Temperature
Oxygen Saturation
Cardiac History
Medications
Allergies
Cardiac Assessment
Heart Sounds
Peripheral Edema
Jugular Venous Distention
Capillary Refill
Skin Color/Temp
Chest Pain
Shortness of Breath
Other Observations