Did the patient correctly repeat all three words?	Yes	No
Thank you. Now,
	Incorrect	Correct
1. Without looking at a calendar or a watch, what year is this?	____ (0)	____ (1)
2. Without looking at a calendar or a watch, what month is this?	____ (0)	____ (1)
3. Without looking at a calendar or a watch, what is the day of the week?	____ (0)	____ (1)
What are the three objects I asked you to remember? (any order is acceptable)
4. Apple	____ (0)	____ (1)
5. Table	____ (0)	____ (1)
6. Penny	____ (0)	____ (1)
Score (sum of items 1–6):	_________ (0–6)