Sixty-fourth note going downward when the note is above or on the middle line of the staff. When the note head is below the middle line the stem is drawn to the right of the note head going upward. A single 64th note is always stemmed with flags, while two or more are usually beamed in groups . A similar, but rarely encountered symbol is the sixty-fourth rest (or hemidemisemiquaver rest, shown on the right of the image) which denotes silence for the same duration as a sixty-fourth note. Notes shorter than a sixty-fourth note are very rarely used, though the hundred
SOAP note patient-specific drug and disease-state monitoring parameters. This should address each item of the differential diagnosis. For patients who have multiple health problems that are addressed in the SOAP note, a plan is developed for each problem and is numbered accordingly based on severity and urgency for therapy. A note of what was discussed or advised with the patient as well as timings for further review or follow-up are generally included. Often the Assessment and Plan sections are grouped together. A very rough example follows for a patient being reviewed following an appendectomy. This example resembles a surgical SOAP note; medical