ipcase002judytidd - Global Care Medical Center 100 Main St...

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Global Care Medical Center 100 Main St, Alfred NY 14802 (607) 555-1234 Hospital No. 999 ° ±²³´°µ±´ ³·µ ¸ ¹µµ´ °±²³´µ² ¶±·´ ±µ¸¹¸¸º´»» ¼´µ¸´º ½±¾´ ¿±º ³²±ÀÁ²±²Â» °±²³´µ² ¶ÃÄ F W S IPCase002 ű²´ ÃÆÇ ³º ²È ¹É´ ¿±³¸´µ ¶±·´ ʾ¾Â˱²³Ãµ TIDD, JUDY 1227 MAIN STREET ALMOND, NY 14804 02/08/YYYY 63 Tidd Landscape Architect ¹¸·³»» ³Ãµ ű²´ Ì ³·´ ų»¾È±ºÉ´ ű²´ Ì ³·´ Í´µÉ²ÈÃÆÁ²± Ì´À ´ËÈõ´ ¶Â·!´º 09/24/YYYY 08:35 09/26/YYYY 10:00 01 DAY (607)555-5535 ¼Â±º±µ²Ãº¶±·´ ±µ¸¹¸¸º´»» ¶´" ² ÃÆ# ³µ ¶±·´ ±µ¸¹¸¸º´»» TIDD, JUDY 1227 MAIN STREET ALMOND, NY 14804 TIDD, GEORGE 1225 MAIN STREET ALMOND, NY 14804 ¼Â±º±µ²ÃºÌ´À ´ËÈõ´ ¶ÃÄ ½´À ±²³Ãµ»È ³Ë²Ã°±²³´µ² ¶´" ² ÃÆ# ³µ Ì´À ´ËÈõ´ ¶Â·!´º ½´À ±²³Ãµ»È ³Ë²Ã°±²³´µ² (607)555-5535 Self (607)555-6986 Brother ¹¸·³²²³µÉ°È » ³¾ ³±µ Á´º$ ³¾´ ¹¸·³² Ì Ë´ ½Ã÷ ¶Â·!´º%Ç´¸ Philip Newman, MD 254 ¹²²´µ¸ ³µÉ°È » ³¾ ³±µ ¹¸·³²²³µÉų±ÉµÃ» ³» Philip Newman, MD Cataract right eye °º ³·±º &µ»Âº´º °ÃÀ ³¾ ±µ¸¼ºÃÂ˶·!´º Á´¾Ãµ¸±º &µ»Âº´º °ÃÀ ³¾ ±µ¸¼ºÃÂ˶·!´º Atena °±²³´µ¶·¶ ²´¸ ¹ºµ»·¸¼º·¶ ½¾° ¾µ¸· °º ³µ¾ ³Ë±Àų±ÉµÃ» ³» Cataract of the right eye Á´¾Ãµ¸±º ų±ÉµÃ»´» Chronic obstructive pulmonary disease °º ³µ¾ ³Ë±À°ºÃ¾´¸Âº´ Extracapsular cataract extraction with implantation of a 16 Diopter posterior chamber lens (Sinskey style posterior chamber lens) in the ciliary sulcus. Á´¾Ãµ¸±º °ºÃ¾´¸Âº´» ų»¾È±ºÉ´ &µ» ²ºÂ¾ ²³Ãµ» A CTIVITY : ° Bedrest ° Light ° Usual ° Unlimited ° Other: D IET : ° Regular ° Low Cholesterol ° Low Salt ° ADA ° °°°°° Calorie F OLLOW -U P : ° Call for appointment ° Office appointment on ° Other: ÁË´¾ ³±À&µ» ²ºÂ¾ ²³Ãµ» : None A TTENDING P HYSICIAN A UTHENTICATION : Reviewed and Approved: Philip Newman MD ATP-B-S:02:1001261385: Philip Newman MD (Signed: 09/24/YYYY 9:04:26 AM EST)
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TIDD, JUDY IPCase002 Dr. NEWMAN Admission: 09/24/YYYY DOB: 02/08/YYYY ROOM: 254 · º±¸µ±´ ´ º ³ »¼°¸¸°º± I, Judy Tidd hereby consent to admission to the Global Care Medical Center (ASMC) , and I further consent to such routine hospital care, diagnostic procedures, and medical treatment that the medical and professional staff of ASMC may deem necessary or advisable. I authorize the use of medical information obtained about me as specified above and the disclosure of such information to my referring physician(s). This form has been fully explained to me, and I understand its contents. I further understand that no guarantees have been made to me as to the results of treatments or examinations done at the ASMC.
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