Using a comma to separate two or more adjectives
Use a single (separating) comma to clarify two or more adjectives that modify the same noun.
The patient is a well-developed, well-nourished woman. (Two adjectives modifying the noun, "woman")
This is a healthy, happy boy. (Two adjectives modifying the noun, "boy")
Exception: The trend in medical record documentation is to omit commas from the series of descriptive adjectives used to identify the patient. Follow specific guidelines of the facility/employer. Typically, this consists of the patient's age, race and gender.
The patient is a 40-year-old Caucasian female.
On examination, he is a 77-year-old African-American? male.
Again, following facility/employer specific guidelines, when the adjectives extend to additional descriptions, use separating commas for those elements, as the string of adjectives becomes too long and visually confusing.
The patient is a well-developed, well-nourished, right-handed 40-year-old Caucasian female.
not
The patient is a well-developed well-nourished right-handed 40-year-old Caucasian female.
Wiki