1. Patient Information

Service Medicine Pediatrics OB-GYN Surgery Age Sex Male Female Other Year of Admission 2022 2023 2024

2. Clinical Presentation

Chief Complaint History of Present Illness (HPI) ACCS Difficulty Score 1 - Very Easy 2 - Easy 3 - Moderate 4 - Difficult 5 - Very Difficult

3. Clinician Diagnostic Hypotheses

Diagnosis 1 (Top Rank) Diagnosis 2 Diagnosis 3