[MEDICAL] Veronica Escribano

[Veronica Escribano]

I. PATIENT INFORMATION

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• Title: (select one)
  • [] Mr.
  • [] Mrs.
  • [X] Ms.
  • [] Other
  First Name:
  Veronica
  
  Middle Name: (optional)
  Angelica
  
  Last Name:
  Escribano
  
  Gender: (select one)
  • [] Male
  • [X] Female
  Date of Birth:
  05/MAR/1985
  
  Address:
  5 Panorama Drive
  

II. CONTACT INFORMATION

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• Phone Number:
  02968885
  
  Email:
  [email protected] ((Jesu1)) (( Include forum name in brackets ))
  
  (( Discord: ))
  jesu1
  

III. APPOINTMENT DETAILS

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• Has the patient been seen at Pillbox Hill Medical Center in the past?
  • [] Yes
  • [X] No
  Does the patient have a diagnosis?
  • [] Yes
  • [X] No
  If so, please describe:
  N/A (N/A if the answer to the previous question is 'No')
  
  Reason for Appointment:
  Physical needed for adoption.
  
  Department:
  • [X] Medical
  • [] Dental
  • [] Mental Health
  Dates & Times for Appointment:
  • [] 10/MAR/2024 - 19:00+
    [] 11/MAR/2024 - 19:00+
    [] 12/MAR/2024 - 19:00+
  Preferred Doctor for Appointment:
  ANSWER

[Kaden Malik]

• Dear Veronica Escribano,
  
  We hope your stay at Pillbox Hill Medical Center was satisfactorily.
  Your appointment request is being archived. Do not hesitate to request another meeting with our practitioners in the future.
  
  To obtain your medical information, please visit Medical Records.
  If you would like to leave a feedback, please visit Questions and feedback.
  
  Thank you for choosing Pillbox Hill Medical Center. Stay safe, and stay healthy. Your Health is our Priority.