Acute Group A Streptococcal Pharyngitis Infection
Appointment
Name
DOB
Age
Phone
Allergies
Primary Care Provider
Symptoms
Sore throat
Pain on swallowing
Fever > 100.4
Runny Nose
Swollen or tender cervical lymph nodes
Headache
Inflammed or swollen tonsils or uvula
Cough
Hoarseness
Red eyes
Diarrhea
Signature
Submit
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