TellLink - Medical Data

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patient information
Patient ID 100001
Name
Date of Birth Nov. 30, -0001
Gender
Ethnicity
Height 0 feet 0 inches
Weight 0 lbs
Bood Type
Chronic Illness Diabetes
Medications Insulin, Lipator
Allergies Penicillin
Organ Donor


Patient


 

  • Patient
  • Insurance
  • Physician
  • Conditions
  • Medications
  • Medical History
  • Family History
Patient Information
Name:   
Address:    , ,  
Phone 1:        Phone 2:        Phone 3:   
Email:   
Emergency Contacts
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Name:    John Boy Doe    Relationship:    Father
Address:    2345 Any St., Apt. 123, Dallas, Texas  75226
Phone 1:    214-111-1111    Phone 2:    972-111-2222    Phone 3:    214-222-1113
Email:    john.boy.doe@something.com

Name:    Janet Anne Doe    Relationship:    Mother
Address:    2345 Any St., Apt. 123, Dallas, Texas  75226
Phone 1:    214-111-1111    Phone 2:    972-111-2222    Phone 3:    214-222-1112
Email:    janet.doe@something.com

Name:    Billy Bob Doe    Relationship:    Brother
Address:    2456 Anyroad Dr., Tulsa, Oklahoma  76276
Phone 1:    918-444-4444    Phone 2:    918-444-4445    Phone 3:    918-444-4446
Email:    billy.bob.doe@something.com
Insurance
SSN:    222-33-4444    DL:    07345689
Company:    Blue Cross Blue Shield Texas
Policy Number:    123456789    Group Number:    B125-C225
Coverage:    PPO
Phone:    800-888-8888
Primary Care Physician
Name:    Dr. Marcus A. Welby, MD    Specialty:    Family Medicine
Address:    9876 Medical Blvd., Suite. 345, Dallas, Texas  75229
Phone 1:    214-333-3333    Phone 2:    214-333-3334
Physicians
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Name:    Dr. Stephen F. Kiley, MD    Specialty:    Family Medicine
Address:    9876 Medical Blvd., Suite. 345, Dallas, Texas  75229
Phone 1:    214-333-3333    Phone 2:    214-333-3334

Name:    Dr. Benjamin F. Pierce, MD    Specialty:   Allergy
Address:    9876 Medical Blvd., Suite. 345, Dallas, Texas  75229
Phone 1:    214-333-3333    Phone 2:    214-333-3334

Name:    Dr. Bradly J. Hunnicut, MD    Specialty:    Endocrinology
Address:    9876 Medical Blvd., Suite. 345, Dallas, Texas  75229
Phone 1:    214-333-3333    Phone 2:    214-333-3334

Name:    Dr. Charles E. Winchester, MD    Specialty:    Surgen
Address:    9876 Medical Blvd., Suite. 345, Dallas, Texas  75229
Phone 1:    214-333-3333    Phone 2:    214-333-3334
Chronic Conditions

Condition:    Diabetes, Type 1
Onset:    2/4/2004    Diagnosed:    2/10/2004    Resolved:    n/a
Physician:    Dr. Bradly J. Hunnicut, MD
Treatment:    Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Duis vitae augue. Sed sollicitudin pede. Etiam facilisis lacus ut erat. Aenean a urna feugiat justo venenatis nonummy. Sed pede. Phasellus at libero. Mauris ac dui. Etiam in magna. Etiam dictum. Morbi congue facilisis elit. Sed sollicitudin nonummy ipsum. Nulla a mi. Etiam egestas, leo id gravida lacinia, felis justo laoreet quam, ut accumsan eros leo ac lectus. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Mauris tincidunt consectetuer nunc.
Conditions

Condition:    Influenza
Onset:    3/1/2008    Diagnosed:    3/2/2008    Resolved:    3/10/2008
Physician:    Dr. Bradly J. Hunnicut, MD
Treatment:    Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Duis vitae augue. Sed sollicitudin pede. Etiam facilisis lacus ut erat. Aenean a urna feugiat justo venenatis nonummy. Sed pede. Phasellus at libero. Mauris ac dui. Etiam in magna. Etiam dictum. Morbi congue facilisis elit. Sed sollicitudin nonummy ipsum. Nulla a mi. Etiam egestas, leo id gravida lacinia, felis justo laoreet quam, ut accumsan eros leo ac lectus. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Mauris tincidunt consectetuer nunc.
Allergies

Allergy:   Penicillin
Onset:    2/4/2004    Diagnosed:    2/10/2004    Resolved:    n/a
Last Occurance:    2/10/2004
Reaction:    Swelling of tounge, throat, face
Physician:    Dr. Bradly J. Hunnicut, MD
Medications

Medication:   Insulin
Start:    2/10/2004    End:    n/a    Dosage:   2 units at mealtime
Physician:    Dr. Bradly J. Hunnicut, MD

Medication:   Lipator
Start:    5/22/2006    End:    n/a    Dosage:   2mm
Physician:    Dr. Marcus A. Welby, MD
Vaccinations

Vaccination:    Tetnus   Date:    9/3/2000
Physician:    Dr. Marcus A. Welby, MD
Medical History

Condition:    Diabetes
Onset:    2/4/2004    Diagnosed:    2/10/2004    Resolved:    n/a
Physician:    Dr. Bradly J. Hunnicut, MD
Treatment:    Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Duis vitae augue. Sed sollicitudin pede. Etiam facilisis lacus ut erat. Aenean a urna feugiat justo venenatis nonummy. Sed pede. Phasellus at libero. Mauris ac dui. Etiam in magna. Etiam dictum. Morbi congue facilisis elit. Sed sollicitudin nonummy ipsum. Nulla a mi. Etiam egestas, leo id gravida lacinia, felis justo laoreet quam, ut accumsan eros leo ac lectus. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Mauris tincidunt consectetuer nunc.
Surgical History

Surgen:    Dr. Marcus A. Welby, MD    Location:    Baylor Medical Center
Type:    Appendectomy    Date:    1/1/2005
Treatment:    Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Duis vitae augue. Sed sollicitudin pede. Etiam facilisis lacus ut erat. Aenean a urna feugiat justo venenatis nonummy. Sed pede. Phasellus at libero. Mauris ac dui. Etiam in magna. Etiam dictum. Morbi congue facilisis elit. Sed sollicitudin nonummy ipsum. Nulla a mi. Etiam egestas, leo id gravida lacinia, felis justo laoreet quam, ut accumsan eros leo ac lectus. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Mauris tincidunt consectetuer nunc.
Family Medical History
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Name:   John Boy Doe    Relationship:    Father
Condition:    Diabetes
Physician:    Dr. Joe M. Gannon, MD    Phone:    555-555-5555
Outcome:    Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Duis vitae augue. Sed sollicitudin pede. Etiam facilisis lacus ut erat. Aenean a urna feugiat justo venenatis nonummy. Sed pede. Phasellus at libero. Mauris ac dui. Etiam in magna. Etiam dictum. Morbi congue facilisis elit. Sed sollicitudin nonummy ipsum. Nulla a mi. Etiam egestas, leo id gravida lacinia, felis justo laoreet quam, ut accumsan eros leo ac lectus. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Mauris tincidunt consectetuer nunc.