Listening Short Test, Question Type, Section 1 - Part 1, Sentence / Form Completion

Part 1: Patient Record Form

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Part 1: Temporary Patient Record Form

Section 1 

Question 1-10

Complete the form below
Write NO MORE THAN THREE WORDS AND/OR A NUMBER for each answer

Temporary Patient Record Form

Name:
Example: Peter Smith

Street address: 1 ___________________________
Suburb: 2 ___________________________
Phone number: 3 ___________________________

Details of injury

Sport: Tennis
Type of injury: Sprained 4 ___________________________
Date of injury: 5 ___________________________

Previous treatment and current problems

The patient’s own doctor advised treatment with 6 ___________________________.
The patient is unable to 7 ___________________________ and he is experiencing pain in his 8 ___________________________ at night, which is affecting his sleep.

Advice given

Stop using the 9 ___________________________
Do regular 10 ___________________________ at home