Laserfiche WebLink
FROM : ST. JOE GAS & BAIT FAX NO. : 12185687272 Jun. 04 2006 08:05PM P7 vlw <br /> IMPORTANT: Please bring this sheet and ALL medications in the appropriate bottle to thA Clinic oil yuu� mss w+w++ c,►. <br /> with your physician after discharge from the hospital. <br /> a <br /> Discharged- FOLLOW-UP VISIT: <br /> Admitted: <br /> — �— -• <br /> Clinic appointment with Dr. <br /> Diagnosis: <br /> on ue< r' o �r at <br /> -AM/ t <br /> Lab work or special instructions: <br /> ALLERGIES- <br /> DIET. <br /> Type . , • . <br /> Instruction given: <br /> MEDICATIONS: HEALTH TEACH I/N�O/TREATMENT. �r��( I)".. f <br /> • Brought in: Yes/No Returned by <br /> r,.S4+'r t arklu rt Nl 4 let a J kj4 <br /> �ac>�u lost 3 v ,•s l a ;j1 <br /> ENVIRONMENT: Discharged home with referral to: <br /> Home Health Care <br /> Public Health: <br /> �Xy�, _ Social Services: <br /> as �r.�Q�Pb r <br /> •� Other: <br /> NOTIFY INCASE OF EMERGENCY? <br /> AMBULANCE: 546-7070 - <br /> CLINIC: 546-8375 <br /> HOSPITAL: 546-7000 <br /> I understand the above instrtions and have received a cop <br /> Discharge Nurse: t` �i l <br /> + Patient or Rep.: <br /> C MMM &GIONAL <br /> NM <br /> CROSBY,MINNESOTA 56441 <br /> PATIENT DISCHARGE PLAN PATIENT COPY <br />