Prenatal Record - National Archives and Records Administration

Instruction 1\lanual for Obstetric Forms
08-42 PAST MEDICAL HISTORY (Continued)
Item Number
Item Number
17. Summary. The summary provides a means 18. Significant his to r y not listed above.
for flagging certain important conditions.
Mark this box to index the history of a
Complete the summary after the entire past
disease or surgical procedure th;t may
medical history has been obtained and re­
affect the outcome of this pregn2-!lcy,
corded in items 6-16. Do not use the sum­
but which is not listed in the Sumnary
mary as a sole guide fo.r obtaining the (Item #17).
past medical history.
October 1962
Reproduced at the National Archives
II.A.208
OB-42