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Year in Review 2021
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Pregnancy Wellness

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Pregnancy Wellness in SC Project ECHO

Age:

Gravida:

Para:

Abortus:

EDC:

GA:

BMI:

Reason to Consult & Overview of OB Problems:

Date:

Vaginal/Cesarean

Term/PreTerm

Sex of Child

Weight:

Complications:

This pregnancy history:

Past medical history & allergies:

Surgeries:

Family Medical History

Other Causes:

Social History

Currently smoke cigarettes?

NoYes

Number of packs per day:

Drink alcohol?

NoYes

Number of drinks per day:

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