物理治療評估表 Treatment date: 108 8/2, 8/9, 8/16, 8/30, 9/6, 9/20, 10/18, 11/15, 12/3, 12/20 109 1/3, 1/17, 1/31, 2/17, 3/6, 3/24, 4/10, 4/24, 4/30, 5/8, 5/22   I.          Personal data 姓名： 身份證字號： 性別：男 生日： 電話： 職業： 住址： II.       Symptom and sign 1.       Symptom (pain scale) and area: Pain on superior side of R’t patella 2.       Present since: 1.5 months ago 3.       Symptom progression: improve / unchanged/ worsen 4.       Onset movement: riding a bicycle 5.