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ADULT REGISTRATION Format Section Patient Informational: PREFERRED NAME: ADDRESS: HOME PHONE NO: CITY: STATE: ZIP: WORK PHONE NO: CELL PHONE NO: EMAIL ADDRESS: GENDER: M / MARITAL STATUS: S M DW SOCIAL
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How to fill out section i patient information
01
To fill out Section I of the patient information, follow these steps:
02
Start by entering the patient's full name, including first, middle, and last names.
03
Next, provide the patient's date of birth.
04
Enter the patient's gender, whether male, female, or other.
05
Provide the patient's contact information, including address, phone number, and email (if applicable).
06
If the patient has any allergies, list them in the provided space.
07
Indicate any current medications the patient is taking.
08
If the patient has any medical conditions or previous surgeries, state them accordingly.
09
Finally, provide emergency contact details, including the name and phone number of a person to contact in case of an emergency.
Who needs section i patient information?
01
Section I of the patient information is needed by medical professionals, healthcare providers, and administrative staff involved in the patient's care.
02
This information is crucial for accurate identification, communication, and understanding of the patient's medical history and conditions.
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