Pediatric Growth Chart

This document is used to record and track the physical development of pediatric patients. It includes measurements of height, weight, and body mass index (BMI) along with corresponding percentile rankings to help assess whether a child is growing appropriately for their age group.

Patient Details

Full Name: {fullName}

Date of Birth: {dateOfBirth}

Sex: {sex}

Patient ID: {patientId}

Physician: {physician}

Measurement Date: {measurementDate}

Growth Metrics

Comments

{comments}

Observations

{#observations}

• {note}

{/observations}

{#requiresFollowUp}

Follow-up Required: Yes

Follow-up Date: {followUpDate}

Reason: {followUpReason}

{/requiresFollowUp}

{^requiresFollowUp}

Follow-up Required: No

{/requiresFollowUp}

Signature

Physician's Name: {signedBy}

Signature Date: {signatureDate}