Cancer Event Report 2222 Home Street Ann Arbor MI 99999 US 5555 Home Street Court Ann Arbor MI 99999 US Evelyn E Everyman J.D. Jane Doe Evelyn Everywoman OR US The DoctorsTogether Physician Group 1007 Health Drive Portland OR 99123 US Medical Oncology Associates 1009 Healthcare Drive Portland OR 99123 US Primary Care Provider 1004 Healthcare Drive Portland OR 99123 US Patricia Patty Primary M.D. The DoctorsTogether Physician Group 1004 Health Drive Portland OR 99123 US 1004 Health Drive Portland OR 99123 US Jane Horvat M.D. The DoctorsTogether Physician Group 1004 Health Drive Portland OR 99123 US The DoctorsTogether Physician Group 1004 Health Drive Portland OR 99123 US
Cancer Diagnosis Malignant neoplasm of breast
Diagnosis Date Primary Site Laterality Histology Behavior Diagnostic Confirmation Grade Stage
4/2/2012 Breast Right Adenocarcinoma, NOS Malignant, Primary Positive Histology 2 IIB
ASSESSMENT Flank pain. Pain on deep palpation of lower back. Other chronic diagnoses as noted above, currently stable.
FAMILY HISTORY Father (deceased)
Diagnosis Age At Onset
Myocardial Infarction (cause of death) 57
Diabetes 40
MEDICATIONS ADMINISTERED
Medication Start Date Stop Date Dose
"Doxorubicin 7/29/2012 None 2mg/mL
Diflucortolone
MEDICATIONS Narrative Text Diflucortolone
INSURANCE PROVIDERS
Payer name Policy type / Coverage type Policy ID Covered party ID Policy Holder
Good Health Insurance Extended healthcare / Family Contract Number 1138345 Patient's Mother
9009 Health Drive Portland OR 99123 US Good Health Insurance 9009 Health Drive Portland OR 99123 2222 Home Street Beaverton OR 97867 Boris Betterhalf 2222 Home Street Beaverton OR 97867 Boris Betterhalf 2222 Home Street Beaverton OR 97867
TREATMENT PLAN ... 4444 Healthcare Drive Ann Arbor MI 99999 US Patricia Patty Primary M.D. Level Seven Healthcare, Inc. 1000 Hospital Lane Ann Arbor MI 99999 US Good Health Hospital Heparin 0.25 ml Pre-filled Syringe Medication Factory Inc.
PROBLEMS ...
Procedures ... 1001 Village Avenue Portland OR 99123 US Community Health and Hospitals 1001 Village Avenue Portland OR 99123 US 1000 Hospital Lane Ann Arbor MI 99999 US Good Health Hospital
RADIATION ONCOLOGY ... 1004 Healthcare Drive Ann Arbor MI 99999 US Christine Curie M.D. Good Health Hospital Radiology 1000 Hospital Lane Ann Arbor MI 99999 US 1000 Hospital Lane Ann Arbor MI 99999 US Good Health Hospital 1004 Healthcare Drive Ann Arbor MI 99999 US Christine Curie M.D. Good Health Hospital Radiology 1000 Hospital Lane Ann Arbor MI 99999 US 1000 Hospital Lane Ann Arbor MI 99999 US Good Health Hospital
RESULTS
Result Type Result Value Relevant Reference Range Interpretation Date
Hemoglobin 13.2 g/dL Normal range for women is 12.0 to 15.5 grams per deciliter Normal 03/19/2008
Leukocytes 6.7 10*9/L Normal white blood cell count range 3.5-10.5 billion cells/L Normal 03/19/2008
Platelets 123 10*9/L Normal white blood cell count range 3.5-10.5 billion cells/L Low 03/19/2008
Hematocrit 35.3 % Normal hematocrit range for female: 34.9-44.5 percent Normal 03/19/2008
Erythrocytes 4.21 10*12/L Normal red blood cell count range 3.90-5.03 trillion cells/L Normal 03/19/2008
Urea nitrogen, Serum Pending Pending Pending March 20, 2008
6.7 billion per liter
SOCIAL HISTORY . . .
VITAL SIGNS
Date / Time: Sept 10, 2012 Sept 1, 2011
Height 177 cm 177 cm
Weight 86 kg 88 kg
Blood Pressure 132/88 128/80