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1. General- unconscious, GCS-4, disoriented to time person and place, appears her age 65, uneven skin pigmentation, light brown color is seen from upper

half of both upper and lower extremities and dark brown on the lower part of the upper and lower extremities, presence of 3-4 mm of vesicle on the lower part of the left arm, asymmetric location of body parts, bilateral atrophy of both upper and lower extremities, arm span equals height, body length from crown to pubis roughly equal to length from pubis to sole, dress is appropriate to time, person, age, place and circumstance. 2. HEENT Head- macrocephalic head, no bumps and lumps, presence of tenderness over the frontoparietal region, 4-5 centimeters away from the two parallel stitches having 1st:10cm, 2nd:7cm, forehead on its normal protrusion, with lateral edge of each parietal bone feels jagged upon palpation, and has depressed area especially on the lower ends of the frontoparietal region, temporal artery appears to be smooth, soft and movable, Left eyebrows is 1.5 cm lower than the right, marked asymmetrical facial features, bilateral periorbital swelling with presence of ecchymoses on the lower end of the upper outer canthus, dry flaking scaly skin covered the head with some flaking dandruff evenly scattered on the parietal and frontal region of the head, head is erected on the midclavicular line, hair is evenly scattered on the left temporal and left part of the occipital region, characterize it as white to gray, dry and coarse.

Ears- ears is normocrotia with 6 cm vertical dimension, lobule and helix of the ear coils back when coiled, outer and middle ear is covered with dried crusted blood, with some dark impacted cerumen, no bumps, lumps and tenderness noted upon inspection and palpation, skin color covering the ears is consistent with other skin covering the face, no bumps, lumps and tenderness noted upon palpation on the mastoid process.

Eyes- Left eyebrows is 1.5 cm lower than the right, marked asymmetrical facial features, bilateral periorbital swelling with presence of ecchymoses on the lower end of the upper outer canthus, pale conjunctiva with numerous minute blood vessels showing-up, presence of hardened discharge bilaterally, eyeballs looks glossy, china-white sclera, clear cornea and lens, iris appears flat, with round regular shape and even coloration, fixed-constricted pupils L=3mm, R=3mm

Nose- Symmetric to other facial parts like the eyes, erected midline, no bumps, lumps and tenderness upon inspection and palpation, middle and inferior

turbinates are covered with dried mucus, green in color, nasal septum is deviated to the left, sinuses are not inflamed.

Throat- lips appears to be pale and turns violet when pressed, cracked, presence of only one teeth out of 32 found on the mandibular region, with crown appears to be black, covered with dark yellow plaque, presence of halitosis upon inspection, gingival hyperplasia is also present, tongue appears to be moistened and pink with white patches covering the posterior 1/3 of the tongues, tonsillar pillar-2+, uvula does not rises on the middle when touched, preauricular, posterior auricular, occipital, Jugulodigastric, superficial cervical, submandibular, submental, posterior cervical, supraclavicular, and deep cervical lymph nodes are movable, smooth and easily palpated 2+.

3. Integumentary- general uneven skin pigmentation, light brown color is seen from upper half of both upper and lower extremities and dark brown on the lower part of the upper and lower extremities, presence of 3-4 mm of vesicle on the lower part of the left arm, asymmetric location of body parts, presence of tenderness over the frontoparietal region, 4-5 centimeters away from the two parallel stitches having 1st:10cm, 2nd:7cm, not raised , Left eyebrows is 1.5 cm lower than the right, , bilateral periorbital swelling with presence of ecchymoses on the lower end of the upper outer canthus, dry flaking scaly skin covered the head with some flaking dandruff evenly scattered on the parietal and frontal region of the head, is evenly scattered on the left temporal and left part of the occipital region, characterize it as white to gray, dry and coarse, general dry scaly skin noted all over the body, fingernails are spoon shaped, dry and has jagged lines, toenails appears to be alternately depressed and some are clubbed <120 degrees, lower part of the upper and lower extremities respectively are warm to touch, while the upper regions of the upper and lower extremities are warm to touch, presence of 7cm of stitched or closed wound over the left lower abdomen, violet-discoloration noted over skin covering the mid-sternaol region. 4. Respiratory- wheezing noted over the upper lobe of the left lung, thorax is symmetric, in an elliptical shape, with downward sloping of the ribs, use of accessory muscle upon breathing, specially the neck muscles, no bumps, lumps and tenderness noted upon inspection and palpation, AP:TR:1:2, hyperesonance and vesicular lungs sounds noted upon auscultation over the lung peripheries, dull note also is noted upon percussion over the lung peripheries, RR=14 cpm 5. Cardiovascular- PMI noted on the 5th ICS Left Midclavicular Line, aortic valve is found on the 2nd right ICS, pulmonic valve2nd left ICS, tricuspid valve is found on

the left lower sterna border, mitral valve over the 5th ICS at around the midclavicular line, s1 is louder than s2 at the apex, s2 is louder than s1 at the base, diastolic murmur is present, Grade ii, low pitched following a pattern of decrescendo best heard upon closure of the semilunar valves, presence of pathologic s4 noted upon asuculatation, preauricular, posterior auricular, occipital, Jugulodigastric, superficial cervical, submandibular, submental, posterior cervical, supraclavicular, and deep cervical lymph nodes are movable, smooth and easily palpated 2+, carotid 2+, brachio-radialis 1+, radial 1+, femoral 2+, popliteal 1+, dorsalis-pedis 1+., PR= 65bpm , BP=140/60mmhg 6. Digestive- protuberant abdomen, hyperactive bowel sound 35 BS/min, presence of 7cm of stitched or closed wound over the left lower abdomen, violet-discoloration noted over skin covering the mid-sternal region, umbilicus is found on the midline and depressed or sunken, surface of the abdomen is smooth, with homogenous color, brown-light brown, Hyperesonance is present after auscultation over the GI peripheries, no bumps, lumps and tenderness upon palpation. 7. Ecretory- February 24 MIO: Urine= , Stool= 8. Muscular- macrocephalic head, , presence of tenderness over the frontoparietal region, 4-5 centimeters away from the two parallel stitches having 1st:10cm, 2nd:7cm, forehead on its normal protrusion, with lateral edge of each parietal bone feels jagged upon palpation, and has depressed area especially on the lower ends of the frontoparietal region, bilateral periorbital swelling with presence of ecchymoses on the lower end of the upper outer canthus, protuberant abdomen, no localize swelling, or bumps and lumps found over the temporomandibular joint, palmar, cervical spine, upper and lower extremities, with general ROM of 0+-1+ (all over the body). 9. Nervous-GCS: 4, NOTE: Client status: Light Coma Cranial Nerves: I (olfactory), II (optic), IV (Trochlear), VII (Facial), VIII (Acoustic), XI (Spinal),X (Vagus), XII (Hypoglossal) was not tested due to current neurological status of the px., III (Oculomotor)-motor eye movement is absent, pupil constriction is fixed L=3mm, R=3mm, V(Trigemminal)-can move maxilla and mandibular muscles lightly, can sneeze, PR=65 bpm, RR=14 cpm, BP=140/60 mmhg, T= 37.6C 10.Endocrine- Female, 65 yrs old, uneven skin pigmentation, light brown color is seen from upper half of both upper and lower extremities and dark brown on the lower part of the upper and lower extremities, bilateral atrophy of both upper and lower extremities, arm span equals height, body length from crown to pubis roughly equal to length from pubis to sole, , dry flaking scaly skin covered the head with some flaking dandruff evenly scattered on the parietal

and frontal region of the head, skin color covering the ears is consistent with other skin covering the face. 11.Reproductive- Female, 69 yrs old, Menopause, left breast is slightly larger than the right, skin appears smooth and has even color, light brown, no bumps, lumps and lesions noted upon inspection and palpation, axillary lymph nodes are not enlarged.