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Patient

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Drug

info

Created By/On: Devel# 11/26/2015 | 5:23:47 AM

Maintained By/On: Jayden Smith 02/12/2018 | 5:06:479 AM

Name: Maria Rodriguez
DOB: 10/07/1976
Patient Type: Compliance Packaging , Care Facility Patient

Service Plan

Task Description	Next Date	Frequency	Active
Record the patient's date of birth (Patient Chart, Master Info)
Record the Patient's gender (Patient Chart, Master Info)
Record the Patient's race (Patient Chart, Master Info)

Response History

Record the patient's date of birth (Patient Chart, Master Info)

Date/Time	Pharmacist	Response			Date/Time

Service Products
AM3000	Diabetes [250.00]
AM1000	Enhance Asthma Management
AM2000	Hypertension
AM4000	Smoking Cessation

Selected Service Products
AM3000	001	Record the age of this patient. (Master Info)
AM3000	002	Record the patient's gender. (Patient Chart, Master Info)
AM3000	003	Does the patient smoke?
AM3000	004	Does the patient have low HDL readings?

Search Criteria

Date of Birth

Enter last name, first name

MRN

Phone

Address

City

State

ZIP

Name Name	Date of Birth Date of Birth	Address Address	City City	State State	ZIP ZIP	Phone Phone	CF CF	Status Status
Annie Wiedman	10/07/1978	88 Center Rd	Bedford	OH	44146	715-361-4850		Active
Maria Rodriguez	12/03/1976	2349 Spinnaker Lane	Joliet	LA	60432	724-376-4350		Active
Scott Adams	08/19/1979	1919 County Line Road	Tampa	FL	33634	727-729-9038		Active
Smith James	04/11/1978	1566 Elm Drive	Cambridge	NY	12816	532-247-7219		Active
Teresa Andresen	11/28/1987	1227 Perine Street	Alexandria	VA	22304	703-823-4297		Active