SES Class
 1 Class I
 2 Class II
 3 Class III
 4 Class IV
 5 Class V


VULNERABILITY
Date:
Hopelessness:
Turmoil:
Frustration:
Depression:
Powerlessness:
Anxiety:
Exhaustion:
Worthlessness:
Abandonment:
Denial:
Truculence:
Repud. of SKO:
Time Persp.
Overall Score:
CO-MORBIDITY
Extent to which


conditions contributed to death.


Central Nervous
Cardiovascular
Pulmonary
Hemotopoietic
Kidneys
Gastrointestinal
Endocrine
Musculo-skeletal
Genital
Total


1