Patient : Care Facility

Patient Care Facility Information

Care Facility

Section/Wing

Floor

Room

Format : 999

Bed

Format : AA

Admission Date

Discharge Date

Batch Label

Compliance Packaging

Care Facility Resident Status

Date Activated:

05/12/2018

Date Ordered	Treatment
	High Fiber, low potassium, low sugar
	All Ice Cream and Chocolate
	Low Salt, Low Sodium, Lots of H2O
	Vegan Diet

Search Criteria

Date of Birth

Enter last name, first name

MRN

Phone

Address

City

State

ZIP

Name	Date of Birth	Address	City	State	ZIP	Phone	Status
Smith James	10/07/1978	88 Center Rd	Bedford	OH	44146	715-361-4850	Active
Rodriguez Maria	10/07/1976	2349 Spinnaker Lane	Joliet	LA	60432	724-376-4350	Active
Smith James	10/07/1978	1566 Elm Drive	Cambridge	NY	12816	532-247-7219	Active