I. PATIENT INFORMATION
- Title: (select one)
- [X] Mr.
- [] Mrs.
- [] Ms.
- [] Other
Samuel
Middle Name:
Francis
Last Name:
Testa
Gender: (select one)- [X] Male
- [] Female
15/07/2007
Address:
300 Spanish Avenue - Floor 3, Room 7
II. CONTACT INFORMATION
- Phone Number:
26469951
Email:
(( US Simon ))
(( Discord: ))
USSimon
Additional Info:
Appointment being made by Dr. Alessia Amato, Medical Director for the Department of Health and Welfare. Please CC me on any information sent to the patient as I will be joining him during this visit. I can be reached at phone number 9891 or by email at [email protected] ((can email me at PHMC Forums or LSGOV Forums. Discord is swifty1989))
III. APPOINTMENT DETAILS
- Has the patient been seen at Pillbox Hill Medical Center in the past?
- [X] Yes
- [] No
- [X] Yes
- [] No
Patient was previously seen by Dr. Alexandra Yonescu regarding past trauma. MRI was conducted.
Reason for Appointment:
Requesting a neurology follow-up to discuss the treatment plan. Additionally, patient needs a yearly eye-exam.
Department:- [X] Medical
- [] Dental
- [] Mental Health
- [] 04/MAR/2024 - 17:00-20:00
[] 05/MAR/2024 - 17:00-19:00
[] 06/MAR/2024 - 17:00-20:00
Any available.