Initial Public Health Case Report

Jane Doe
Patient Identifiers
PT-470126 Meaningless identifier, not to be used for any actual entities. Examples only.
444-44-4444 United States Social Security Number

About

Date of Birth
10/2/1990
Sex
Female
Race
Native Hawaiian or other Pacific Islander
Ethnicity
Not Hispanic or Latino

Contact

Home

2222 Home Street

Houston, TX

77002, US

tel: (Primary Home) 555-555-2003
email: (Primary Home) janedoe@email.com

Emergency Contact

Mr Emer Contact
()

Contact

tel: (Mobile Contact) +1-334-304-2665

Author

Time:
05/5/2020, 15:00
OID: 2.16.840.1.113883.3.72.5.20

Contact

Work Place

1234 Facility Drive

Houston, TX

77002

tel: (Work Place) 555-777-0123
fax: (Work Place) 555-777-0987

Encounter

Identifier
9937015 OID: 2.16.840.1.113883.19
Type
Office outpatient visit 15 minutes
Date
From: 05/13/2020
To: 05/13/2020
Location
Outpatient Facility

Responsible Party

Assigned Amanda, of Houston Urgent Care Clinic

Contact

Home

1234 Provider Street

Houston, TX

77002, US

tel: (Work Place) 555-777-0123
fax: (Work Place) 555-777-0987

Encounters

EncounterDate(s)Location
Office outpatient visit 15 minutes05/13/2020Houston Urgent Care Clinic

History of Present Illness

No history of present illness

Medications Administered

No medications administered

Problem List

No problems reported

Reason for visit

Results

Results PanelDate(s)
SARS-like Coronavirus N gene [Presence] in Unspecified specimen by NAA with probe detection
  • *** In the table below, row entries with values under RCTC columns triggered this Electronic Initial Case Report (eICR)

    TestLab Test RCTC OID ***Lab Test RCTC Version ***OutcomeDate(s)Lab Result RCTC OID ***Lab Result RCTC Version ***
    SARS-like Coronavirus N gene [Presence] in Unspecified specimen by NAA with probe detection2.16.840.1.114222.4.11.750820200429Detected (qualifier value)05/13/2020

Plan of Treatment

*** In the table below, row entries with values under RCTC columns triggered this Electronic Initial Case Report (eICR)

Lab Test OrderCodeCodeSystemRCTC OID ***RCTC Version ***Ordered Date
SARS-like Coronavirus N gene [Presence] in Unspecified specimen by NAA with probe detection94310-0 LOINC05/13/2020

Social History

Birth SexValueDate
Sex Assigned At BirthFemale10/02/1990
Social History Observation TypeValueDates(s)
Occupation / Employment detailsPostsecondary teachers
Pregnancy StatusNo

Document maintained by

Houston Urgent Care Clinic

Contact

Work Place

1234 Facility Drive

Houston, TX

77002

tel: (Work Place) 555-777-0123

Document Information

Document IdentifierDocument Created
OID: 10c13861-86a8-4a9a-aec6-b615921178df05/5/2020, 15:00