Patient | Doe, Jane |
Patient ID(s) | PT-470126 2.16.840.1.113883.19.5
444-44-4444 2.16.840.1.113883.4.1 |
Contact info | Home:
2222 Home Street Houston, TX 77002, US |
Date of Birth | October 2, 1990 |
Sex | Female |
Race | Native Hawaiian or other Pacific Islander |
Ethnicity | Not Hispanic or Latino |
Primary Information Recipient: | Amanda, Assigned |
Contact info | Home:
1234 Provider Street Houston, TX 77002, US |
eICR Identifier: | 10c13861-86a8-4a9a-aec6-b615921178df |
Public Health Reporting Communication: one or more conditions are reportable, or may be reportable, to public health.
Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient.
"Coronavirus infection (disorder)" is reportable to "Houston Health Department". The initial case report was sent to "Houston Health Department". Additional information may be required for this report.
"Coronavirus infection (disorder)" for "Houston Health Department"
Reporting is required immediately. Reporting to this Public Health Agency is based on "Both patient home address and provider facility address"
> CDC COVID-19 webpage (Information only)
> Houston Health Department Epidemiology Web Page (Information only)