Your Review of Systems is subjective information from the patient standpoint in a positive and negative narration, so if this patient is coming in with a rash then you want to put they are positive for a rash under the right axilla. They are positive for a fever and fatigue, but they don't complain of chills so negative for chills. You could either record signs and symptoms and the body systems as positive and negative (which is how I documented my practice) or you can't say 'patient states they are having XYZ symptoms' if you use certain words you want to put it to this, but you want to make it very clear and consistent whether you are stating the positive per the patient and negative for the patient that you use the same verbiage so it is clear what symptoms are present and what symptoms are not present from the patient's standpoint. Again, this is not your Objective exam. You don't want to confuse this with your Objective exam. This is subjective information per your patient interview that you put in positive and negative narration or description.