This is shocking. Funnily enough I was at a course today wand a consultant paediatrician was showing us copies of crap referral letters from GPs- and tere was one that read a lot like this patient you saw - along the lines of "this child is drinking a lot, passing a lot of urine and has abdo pain. Please see and treat" No urinalysis. No BM. There's no excuse. Without exception we were all (all of us GPs) cringing and saying that we can't believe there are still people out there like that. It's a sad fact that it is true. Probably more true in cities than elsewhere. But there are some of us who, if not heroic, do a bit better than this at least.