Initial Public Health Case Report
Everyman Adam
Patient Identifiers
PT-470125 Meaningless identifier, not to be used for any actual entities. Examples only.
333-33-3333 United States Social Security Number
About
Date of Birth
09/13/1967
Sex
Male
Race
Black or African American
Ethnicity
Not Hispanic or Latino
Contact
Home
0987 Home Street
Provo, UT
84601, US
tel: (Primary Home) 555-555-2003
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
1002 Healthcare Drive
Provo, UT
84601
tel: (Work Place) 555-777-0123
fax: (Work Place) 555-777-0987
Encounter
Identifier
9937014 OID: 2.16.840.1.113883.19
Type
Office outpatient visit 15 minutes
Date
From: 05/12/2020
To: 05/12/2020
Location
Outpatient Facility
Responsible Party
Harold Hippocrates, MD of Provo Outpatient Clinic
Contact
Home
1002 Healthcare Drive
Provo, UT
84601, US
tel: (Work Place) 555-777-0123
fax: (Work Place) 555-777-0987
Encounters
Encounter | Date(s) | Location |
---|---|---|
Office outpatient visit 15 minutes | 05/12/2020 | Provo Outpatient Clinic |
|
History of Present Illness
Patient thinks he was in contact with a COVID-10 positive person;
Medications Administered
No medications administered
Problem List
No problems reported
Reason for visit
Patient thinks he was in contact with a COVID-10 positive person
RESULTS
Lab Test Name | Lab Test Result Value | Lab Test Result Date |
---|---|---|
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Plan of Treatment
*** In the table below, row entries with values under RCTC columns triggered this Electronic Initial Case Report (eICR)
Lab Test Order | Code | CodeSystem | RCTC OID *** | RCTC Version *** | Ordered Date |
---|---|---|---|---|---|
SARS-related coronavirus RNA [Presence] in Unspecified specimen by NAA with probe detection | 94647-5 | LOINC | 05/12/2020 |
Social History
Birth Sex | Value | Date |
---|---|---|
Sex Assigned At Birth | Male | 09/13/1967 |
Social History Observation Type | Value | Dates(s) |
---|---|---|
Occupation / Employment details |
Document maintained by
Provo Outpatient Clinic
Contact
Work Place
1002 Healthcare Drive
Provo, UT
84601
tel: (Work Place) 555-777-0123
Document Information
Document Identifier | Document Created |
---|---|
OID: 40fc3506-f9c2-45bf-a4f8-cbfe5cf744e8 | 05/5/2020, 15:00 |