What is the
Year
Season
Day of the week
Month
Date

Where are we now?
State
County
Town/city
Hospital
Floor

Name 3 unrelated objects, ask subject to recite them now and remember them for later. E.g.
Apple
Table
Penny

Count backward from 100 by sevens/or spell world backwards:
93/D
86/L
79/R
72/O
65/W

Name the three things asked to remember earlier. E.g.
Apple
Table
Penny

Name objects shown to patient:
Wristwatch
Pen or pencil

Repeat the phrase:
"No ifs, ands, or buts."

Follow these instructions:
"Take the paper in your right hand,
fold it in half,
and put it on the floor.

Read and follow the instructions:
Close your eyes

Make up and write a sentence about anything, which contains a noun and a verb:
Sentence acceptable

Please copy this picture (intersecting pentagons with a four-sided intersection):
Picture acceptable

MMSE score: