| Name | Ellen Ross |
| Age | 52 |
| Sex | F |
| Date of Birth | 03/07/1960 |
| Language | English |
| Phone | 415-555-1229 |
| Mailing Address |
17 Dawson Road #216
Portland, OR 97006 More Demographics |
Severe Allergies
Bee Stings,
Penicillin,
Codeine
Active Medications
Latest Lab Results
Upcoming Activity
Last Visit Summary
| Past Due |
Lipitor
|
| Active | Amlodipine Besylate |
| Active | Evista |
| Active | Klonopin |
| Date of Visit | 11/20/2012 11:00 am |
| Location | Ashby Medical Center |
| Ordered By | Ashby Medical Center |
| Labs Ordered | Lipid Panel, Complete Blood Count, Urinalysis |
Demographics
Validating this section with your primary provider will mean you don't need to fill it out again unless your data changes. Notify your primary physician's office if your information is incorrect.
| First Name | Ellen |
| Middle Name | -- |
| Last Name | Ross |
| Alias | Ellen |
| DOB | 03/07/1960 |
| Language |
English
|
| Sex | F Female |
| Marital Status | Married |
| Ethnicity | Asian |
| Religious Affiliation | Christian |
| Home Phone | 415-555-1229 |
| Email Address | ellenross@emailaddress.com |
| Mailing Address | 17 Dawson Road |
| Address Cont'd | Apt 216 |
| City, State Zip | Portland, OR 97006 |
Guardian
The patient has verified that this section of their PHR is up to date and correct as of November 12, 2012 10:08 am.
Has something changed?
Notify your primary physician's office
of any changes.
| First Name | Martha |
| Last Name | Shan |
| Relationship | Sister |
| Home Phone | 816-276-6909 |
| Work Phone | 816-060-6060 x060 |
| Cell Phone | 816-070-7070 |
| Mailing Address | 1357 Amber Drive |
| City, State Zip | Beaverton, OR 97006 |
Medications
Most pharmacies can set up automatic refills so you don't run out of important prescriptions. Sign up for them today and get online notifications when youre prescriptions are ready.
| Medication | Psuedoephedrine 60mg Tab |
| Status | Unknown |
| Dose/Frequency | 1 tablet / once daily |
| Date | 04/11/2009 |
| Medication | Naproxen 500mg Tab |
| Status | Expired |
| Dosage/Frequency | 1 tablet / once daily |
| Date | 08/14/2009 |
| Medication | Indomethtacin 50mg Tab |
| Status | Expired |
| Dosage/Frequency | 1 tablet / twice daily |
| Date | 10/10/2003 |
Plan of Care
| Planned Activity | Office Consultation |
| Status | Past Due |
| Date |
11/29/2012
|
| Instructions | Do not eat or drink 12 hours before appointment. |
| Comments | Missed appointment with Dr. Seven. Reschedule online |
| Planned Activity | Chest X-Ray |
| Status | Upcoming |
| Date | 1/02/2013 1:00 pm |
| Instructions |
| Planned Activity | MRI |
| Status | Upcoming |
| Date | 2/23/2013 11:00 am |
| Instructions |
| Planned Activity | Sputum Culture |
| Status | Upcoming |
| Date | 1/11/2013 2:00 pm |
| Instructions |
There are many healthy activities that can help improve everyone's health. Try fitting some of our recommended practices into your routine.
Medical History
| Observation | Vertigo |
| Status | Active |
| Date | 08/22/2012 |
| Provider | Dr. Henry Seven |
| Location | Ashby Medical Center |
| Comments | Feels dizzy while at work |
| Observation | Cholecystitis |
| Status | Inactive |
| Date | 10/28/2012 |
| Provider | Dr. Henry Seven |
| Location | Ashby Medical Center |
| Comments | Surgery postponed for a few days. |
| Observation | Migraine Headache |
| Status | Active |
| Date | 09/02/2012 |
| Provider | Dr. Henry Seven |
| Location | |
| Comments | Blinding pain and sensitivity to light |
| Observation | Ankle Sparin |
| Status | Inactive |
| Date | 03/28/2012 |
| Provider | Dr. Henry Seven |
| Location | Ashby Medical Center |
| Comments | Slipped on ice and fell. |
| Encounter | Office Consultation Followup |
| Date |
11/29/2012
|
| Provider | Dr. Henry Seven |
| Location | Ashby Medical Center |
| Comments | Followup needed |
| Encounter | ED Visit for Acute Cholecystitis |
| Date | 08/22/2012 |
| Provider | Dr. Tim Lee |
| Location | Ashby Medical Center |
| Comments |
| Encounter | ED Visit for Ankle Sprain |
| Date | 03/28/2012 |
| Provider | Dr. Candice Shah |
| Location | Ashby Medical Center |
| Comments | Ankle sparined while training for half-marathon. Told to stay off it 3 weeks. |
| Encounter | Office Consultation |
| Date | 11/20/2012 |
| Provider | Dr. Henry Seven |
| Location | Ashby Medical Center |
| Comments | Cholesterol a little high, otherwise healthy visit! |
| Encounter | Annual Physical |
| Date | 06/14/2012 |
| Provider | Dr. Henry Seven |
| Location | Ashby Medical Center |
| Comments | All normal results |
| Encounter | Labor and Delivery |
| Date | 03/18/2012 |
| Provider | Dr. Tiffany Martinez |
| Location | Ashby Medical Center |
| Comments | Emergency C-section required |
| Procedure | Gall Bladder Surgery |
| Date | 08/24/2012 |
| Provider | Dr. Bala Venktaraman |
| Location | Ashby Medical Center |
| Comments | Surgery postponed two days. |
| Procedure | LASIK |
| Date | 01/04/2012 |
| Provider | Dr. Priya Subramanian |
| Location | Tesla Vision Institute |
| Comments |
| Procedure | Cesarian Section |
| Date | 03/19/2012 |
| Provider | Dr. Tiffany Martinez |
| Location | Ashby Medical Center |
| Comments | Emergency C-section successful. Healthy baby boy. |
Lab Results
| Date Collected | 11/20/2012 11:15 am |
| Ordered By | Ashby Medical Center |
| Labs Ordered | Lipid Panel, Complete Blood Count, Urinalysis |
Your body mass index (BMI) calculation is a measure of body fat based on height and weight, which is a reliable indicator fo obesity. Check out the National Heart Lung and Blood Institute BMI calculator to see where this number came from and what steps you can take to improve your BMI
| Appearance | Pale yellow |
| Odor | None |
| Turbidity | Slightly cloudy |
| Red Blood Cells | 3.2 / HPF |
| White Blood Cells | 1.5 / HPF |
| Casts | 0 / HPD |
| Crystals | Negative |
| Bacteria | 815.9 |
| Parasites | Negative |
| Acidity (PH) | 6.1 acidic |
| Specific Gravity | 1.014 |
| Protein | Negative-Trace |
| Glucose | Negative |
| Ketone | Negative |
| Bilirubin | Negative |
| Leukoesterase | Trace |
| Nitrate | Negative |
| Date Collected | 08/22/2012 11:37 pm |
| Ordered By | Ashby Medical Center |
| Labs Ordered | CBC, Abdominal x-ray |
Your lab results show that you had a higher than normal white blood cell (WBC) count, which can indicate that your body is fighting off an infection. Learn more about what this panel of tests means at this informative website.
| Date Collected | 06/14/2012 2:30 pm |
| Ordered By | Ashby Medical Center |
| Labs Ordered | Pap Smear |
Allergies
| Allergy Name | Bee Stings |
| Date | 08/01/1980 |
| Severity |
Severe
|
| Reaction | Anaphylactic Shock |
| Allergy Name | Codeine |
| Date | 08/01/1999 |
| Severity |
Moderate
|
| Reaction | Watery eyes, itchy nose |
| Allergy Name | Penicillin |
| Date | 08/01/1980 |
| Severity |
Moderate/Severe
|
| Reaction | Severe hives |
Immunizations
| Immunization | Influenza - H1N1 |
| Date | Upcoming |
| Type | Injection |
| Instructions | Possible flu-like symptoms for 3 days. |
| Immunization | Meningococcal Conjugate |
| Date | 06/2003 |
| Type | Intramuscular injection |
| Dose Quantity | 0.5 / mL |
| Reaction |
Brief fainting spell
|
| Immunization | Tetanus and diptheria toxoids, IM |
| Date | 04/2000 |
| Type | Intramuscular injection |
| Dose Quantity | 50 / mcg |
| Reaction |
Pain
|
| Immunization | Pneumococcal polysaccaride |
| Date | 02/2003 |
| Type | Intramuscular injection |
| Dose Quantity | 0.5 / mL |
| Reaction |
| Immunization | Influenza virus vaccine, IM |
| Date | 05/2001 |
| Type | Intramuscular injection |
| Dose Quantity | 50 / mcg |
| Comments | Had no reaction. |
Providers
| Institution | Ashby Medical Center |
| Phone | 416-555-1200 |
| Mailing Address | 1002 Healthcare Dr #200 |
| City, State Zip | Portland, OR 97266 |
| Last Visit | 11/20/2012 |
Or is it time to find a new one? Find a complete list of providers in your area who accept your insurance at this handy website.
| Source | MyInsurance Patient Portal |
| Source URL | http://patient-portal.myinsurance.com/export |
| Export Method | TXT Download |
| Export Date | 08/19/2012 |
| SHA-256 Hash |
b94d27b9934d3e08a52e52d7da7dabfa
c484efe37a5380ee9088f7ace2efcde9 |
Your Personal Health Record (PHR) is super private. We don't share your information with anyone that would make you feel uncomfortable. Here we will say other phrases in legalese that make people feel a little better about giving out their personal information.
Your PHR is easy to read at a glance through the colored bard on the side of each subsection. Here's a quick quite to what each color tells you:
|
New addition, active status without need for immediate attention |
|
Good status, mild reaction; item is active |
|
Moderate status, moderate reaction; item is in progress |
|
Critical status, severe reaction; item needs immediate action |
|
Status is unknown |
|
Item has expired |
Last Visit Summary
Demographics
Guardian
Medical History
Immunizations
Providers
1
