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

EncounterDate(s)Location
Office outpatient visit 15 minutes05/12/2020Provo 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

Results PanelDate(s)
SARS-related coronavirus RNA [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-related coronavirus RNA [Presence] in Unspecified specimen by NAA with probe detection 2.16.840.1.114222.4.11.750820200429Not Detected05/13/2020

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-related coronavirus RNA [Presence] in Unspecified specimen by NAA with probe detection 94647-5LOINC05/12/2020

Social History

Birth SexValueDate
Sex Assigned At BirthMale09/13/1967
Social History Observation TypeValueDates(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 IdentifierDocument Created
OID: 40fc3506-f9c2-45bf-a4f8-cbfe5cf744e805/5/2020, 15:00