I owned this as a nurse in a clinical setting, but there are no markings whatsoever, and since I rarely used it, it's practically new. ✔︎ No writing, highlighting, or folds ✔︎ Both the cover and the contents are in beautiful condition ✔︎ No tears or missing pages This book is recommended for: * New nurses * Studying for your assigned department * Reviewing after a break * Quick reference in the field ※ Please refrain from purchasing if you are looking for a perfectly new item, as it has been stored at home.