The admission interview was conducted by midwife imuk on december 27 th 2017. The patient was Mrs.

Inna usnia, 25 years old, muslim, married, a housewife, javanes. The address is kebakalan, porong. Her
telephone number is 085655526733. Her problem is morning sickness since 5 days ago. She has 1 son 3
years old. He was born on february, 2nd, he was healty, at independent midwife, normal, term. His weight
was 4000 gram. Now, Mrs Inna is pragnant, her last menstrual period was on november 15 th 2017. She
used 3-month contraceptives for 1 year, and weight gain. Menarche when she was 14 years old, never
had problem, regular every month, normal.

1. Name inna usnia

2. Age 25 years old

3. Nasionality&Race Javanes

4. Address&telephone kebakalan, porong. 085655526733

5. Religion muslim

6. Marital status married

7. Occupation Housewife

Chief complaint Morning sickness

History of present illnes relates to the chief complain or problem

1. Date and time onset since 5 days ago

2. specific location -

3. Type of pain or discomfort -

Menstrual history

1. Age at menarche 14 years old

2. Duration 7 days & regular every month

3. Last menstrual period 15 november 2017

4. Dysmenorrhea -

Obstetric history

1. Gravida/para She has 1 son & this is second pregnancy

2. Each pregnancy

a. Date of termination 2 february 2014

1. Name inna usnia

b. Weeks gestation 40 weeks (aterm)

c. Place of delivery independent midwife

d. Any problem during pregnancy, labour and -

postpartum period?

e. Weight of baby birt 4000 gram

f. Sex of baby boy

g. Any complication -

h. Status of infant at birth i. Present status of infant Healthy

Contraceptive history

Present contraceptive method

a. Type 3-month contraceptives

b. Side effect Weight gain

c. Length of time using this 1 year