Initial Public Health Case Report

Kid Karri
Patient Identifiers
PT-470123 Meaningless identifier, not to be used for any actual entities. Examples only.
555-55-5555 United States Social Security Number

About

Date of Birth
10/27/2002
Sex
Female
Race
Asian
Ethnicity
Not Hispanic or Latino

Contact

Home

2222 Home Street

Salt Lake City, UT

84101, US

tel: (Primary Home) 555-555-2005
email: (Primary Home) kkkidd@email.com

Parent/Guardian

Martha Mum

Contact

Home

2222 Home Street

Salt Lake City, UT

84101, US

email: (Primary Home) mmmum@email.com
tel: (Primary Home) 555-555-2005

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

0987 Facility Drive

Salt Lake City, UT

84101

tel: (Work Place) 888-000-9999
fax: (Work Place) 888-000-1111

Encounter

Identifier
9937012 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

Henry Seven, MD of Utah Outpatient Clinic

Contact

Home

1234 Provider Street

Salt Lake City, UT

84101, US

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

Encounters

EncounterDate(s)Location
Office outpatient visit 15 minutes05/13/2020Utah Outpatient Clinic

History of Present Illness

Since May 10, 2020 the patient has had difficulty breathing and a fever;

Medications Administered

No medications administered

Problem List

ConcernConcern StatusDate(s)
Problemactive05/13/2020
  • *** In the table below, row entries with values under RCTC columns triggered this Electronic Initial Case Report (eICR)

    Problem TypeProblemDate(s)CodeCode SystemRCTC OID ***RCTC Version ***
    symptomDifficulty Breathing )finding)05/13/2020230145002SNOMED-CT
    symptomCoronavirus infection (disorder)05/13/2020186747009SNOMED-CT2.16.840.1.114222.4.11.750820200429

Reason for visit

Patient believes they have Covid-19

Results

No Lab Results

Plan of Treatment

Nothing to report in plan of care section

Social History

Birth SexValueDate
Sex Assigned At BirthFemale10/27/2002
Social History Observation TypeValueDates(s)
Occupation / Employment details
Pregnancy StatusNo

Document maintained by

Utah Outpatient Clinic

Contact

Work Place

0987 Facility Drive

Salt Lake City, UT

84101

tel: (Work Place) 888-000-9999

Document Information

Document IdentifierDocument Created
OID: e91bc1e8-2523-4047-a663-1e3e0781294805/5/2020, 15:00