Complete the following extract from a standard form used for the system review in taking a clinical history.

System Review (contd.)

URINARY TRACT: disease, dysuria, hematuria, frequency, polyuria, hesitancy, incontinency, nocturia, kidney , infections, analgesic abuse, abnormal urine test:

MALE: penile discharge, lesion, veneral disease , testicular pain / mass, sexual dysfunction, undescended testis:
FEMALE: A) Gynecologic history: age of menarche _______, last menstrual _______, age of menopause _______, postmenopausal bleeding, abnormal menses, of bleeding, intermenstrual bleeding, postcoital bleeding, discharge, pruritus, sexual dysfunction, veneral disease history:
B) Obstetric history: full-term deliveries _____ , pregnancies _____ , abortions _____ , _____ , living children _____ , contraception methods __________ , complication of pregnancy:

MUSCULO - SKELETAL: arthritis, pain, edema, heat, redness, , deformity, myalgias:

ENDOCRINE: thyroid disease, diabetes mellitus, goiter, heat cold intolerance, polyuria, polyphagia, hirsutism, change in , hormone :

PSYCHIATRIC: psychiatric / treatment: