Name:

[Name]

Date of Birth:

[Date]

Patient ID:

[119029384]

Diagnosis:

Acute Upper Respiratory Infection

Date of Examination:

[Date]

Symptoms:

Fever, cough, sore throat, fatigue

Duration of Absence:

3 days ([Date] - [Date])

Work/School Limitations:

Patient should refrain from work/school activities during recovery.

Treatment:

Rest, hydration, over-the-counter pain relief, and follow-up in 3 days if symptoms persist.