Patient | Adam, Everyman |
Patient ID(s) | PT-470125 2.16.840.1.113883.19.5
333-33-3333 2.16.840.1.113883.4.1 |
Contact info | Home:
0987 Home Street Provo, UT 84601, US |
Date of Birth | September 13, 1967 |
Sex | Male |
Race | Black or African American |
Ethnicity | Not Hispanic or Latino |
Primary Information Recipient: | Hippocrates, Harold |
Contact info | Home:
1002 Healthcare Drive Provo, UT 84601, US |
eICR Identifier: | 40fc3506-f9c2-45bf-a4f8-cbfe5cf744e8 |
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.
"Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)" is reportable to "Utah Department of Health". The initial case report was sent to "Utah Department of Health". Additional information may be required for this report.
"Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)" for "Utah Department of Health"
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)
> Public Health Agency Contact Information (Information only)
Additional Resources:
> (Information only)