170.315_b1_toc_gold_sample2 test data 1357 Amber Dr Beaverton OR 97006 US Richard Maur jr Community Health and Hospitals 1002 Healthcare Dr Portland OR 97266 US 1002 Healthcare Dr Portland OR 97266 US Mary McDonald 1002 Healthcare Dr Portland OR 97266 US Henry Seven Caroline Maur Community Health and Hospitals 1002 Healthcare Dr Portland OR 97266 US Dr Henry Seven Community Health and Hospitals 1357 Amber Dr Beaverton OR 97006 US Mr. Issac Maur 1357 Amber Dr Beaverton OR 97006 US Ms Caroline Maur Primary Care Provider 1002 Healthcare Dr Portland OR 97266 US Dr Henry Seven Community Health and Hospitals 1002 Healthcare Dr Portland OR 97266 US 1002 Healthcare Dr Portland OR 97266 US Mary McDonald
ALLERGIES AND ADVERSE REACTIONS No Known Drug Allergies
MEDICATIONS No known Medications
Admission Medications No Medications Administered
Discharge Medications No Information
Problem List
Name Dates Location/Qualifier Status
Below Knee Amputation Onset: Apr 2 2014 Left Active
Community Acquired Pneumonia Onset: February 27 2014 Active
ENCOUNTERS No Encounters
Procedures No Information
MEDICAL EQUIPMENT Patient has no history of implantable devices
IMMUNIZATIONS No immunization history Vaccination
VITAL SIGNS No Recorded Vital Signs
SOCIAL HISTORY
Social History Observation Description Dates Observed
Current Smoking Status Current every day July 22, 2015
Birth Sex Male July 22, 2015
RESULTS Laboratory Test: None needed. Laboratory Values/Results: No Lab Result data
ASSESSMENTS No assessment information
TREATMENT PLAN No Plan of treatment
Goals Section No goal information
Health Concerns No Known Health Concerns on 07/22/2015
HOSPITAL DISCHARGE INSTRUCTIONS Appointments: Schedule an appointment with Dr Seven after 1 week. Follow up with Outpatient facility. In case of fever, take Tylenol as advised in plan of treatment.
MENTAL STATUS No information
FUNCTIONAL STATUS No information
Interventions Section No intervention information