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Patient Information Report
--- Provided by Intake Solutions, Inc. --- |
Here is your printable report (no changes made):
Patient's Name: | O'Brien, Michael DOB: 12/31/1944 Last updated: 03/29/2017 | |
Physician's care: | I. M. Quack, 703-555-5554 | |
Use tobacco: | Yes | |
Sulfa Drugs: | Yes | |
Convulsions: | Yes | |
Epilepsy/Seizures: | Yes | |
High Blood Pres: | Yes | |
Comments: |
First paragraph of comment. Second paragraph of comment. | |
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