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NAME Address, Home Phone, Cell Phone, Email DOB 5/24/73 SS# 289-XX-XXXX ALLERGY: Sulfa Drugs, Adhesive Tape - High intelligence (130 IQ), compliant patient, high tolerance to pain - Incomplete Quad (has sensation), o
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Document Date: 2011-10-11 11:19:10


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City

Gainesville / /

Facility

HOSPITAL North FL Regional Medical Center / /

MedicalCondition

Respir Failure Recurrent pneumonia / XXXX ALLERGY / pain / Org NOS Respiratory insufficiency / TB / Gastro Status ORTHOPEDIC Severe deformities / Mumps / Severe Anterior Horn Cell disease / tablets diarrhea / Measles / Chronic RLL Atelectasis / Tetanus / IMMUNIZATIONS Flu / flexion contractures / /

MedicalTreatment

ACUPUNCTURE / IMMUNIZATIONS / /

Organization

RESPIRATORY Respiratory / North FL Regional Medical Center / /

/

Position

BC/BS Case Manager / Manager Debra XXXXXXX 800-392-xxxx ext. / /

Product

Temazepam / H S / Alprazolam / atropine / DuoNeb 1 / Darvocet-N / Cyanocobalamin / DuoNeb / xanax / Zithromax / /

ProvinceOrState

Maryland / /

Technology

cellular telephone / /

SocialTag