Most headaches in general practice are ordinary tension headaches but with associated features one must test: i. Headache with fever: test for neck stiffness to rule out meningitis or meningism due to other disease. ( malarial fever also gives headache) ii. Headache with excessive thirst: check with blood sugar level for hyper or hypoglycemia. iii. As routine: . Check B.P for hypertension . Check sinus tenderness and look for any focus of infection in teeth, tonsil & ears. . If there is any neurological sign as weakness of cranial nerves or limbs,refer immediately for C.T. scan and Neurologist s opinion. PS. If it is simple tension headache you need just an analgesic and may be a tranquiliser.