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SOAP
subjective, objective, assessment, plan
Hx
history
Dx
diagnosis
Tx
treatment
Sx
symptoms
Rx
prescription
Eval
evaluation
Re-eval
re-evaluation
Pt
patient
Wt
weight
Ht
height
Sx (surgery)
surgery
L
left
R
right
B
bilateral
c/o
complains of
s/p
status post (after)
c
with
s
without
a
before
p
after
q
every
q.d.
every day
q.h.
every hour