Sample CRD Document


    Sample CRD Document
    
    
    

    
        
            
            
            
            
                
                    Henry
                    Levin
                    the 7th
                
                
                
                
            
            
                
                Good Health Clinic
                
                
            
        
    


    
        
        
            
            
            
        
    
    
        
            
                
            
        
    

    
        
            
                
                

            
        
    


    
         
        
            
                
                    
                    
                    
                    Active Problem Concern
                    
                        
                            
                                
                                    Problem
                                    Date of Onset
                                
                            
                            
                                
                                    Patient has exercise induced asthma
                                    1/10/2007
                                
                            
                        
                    
                    
                        
                            
                            
                            
                            
                            
                            
                            
                            
                            
                                
                                
                            
                            
                                
                                    
                                    
                                    
                                    
                                    
                                    
                                        
                                    
                                    
                                    
                                    
                                    
                                    
                                        
                                            
                                            
                                            
                                            
                                            
                                            
                                                
                                            
                                            
                                            
                                            
                                        
                                    
                                    
                                    
                                    
                                    
                                        
                                            
                                            
                                            
                                            
                                                
                                            
                                            
                                            
                                        
                                    
                                    
                                    
                                    
                                    
                                    
                                        
                                            
                                            
                                            
                                            
                                            
                                                
                                            
                                            
                                            
                                        
                                    
                                    
                                    
                                    
                                        
                                            
                                            
                                            
                                            
                                                
                                            
                                            
                                            
                                                
                                                
                                                    
                                                    
                                                    
                                                    
                                                        
                                                    
                                                    
                                                        
                                                        
                                                        
                                                    
                                                
                                            
                                        
                                        
                                    
                                    
                                    
                                    
                                        
                                            
                                            
                                            
                                            
                                                
                                            
                                            
                                            
                                                
                                                
                                                    
                                                    
                                                    
                                                    
                                                        
                                                    
                                                    
                                                        
                                                        
                                                        
                                                        
                                                    
                                                
                                            
                                        
                                    
                                
                            
                            
                            
                            
                            
                                
                                    
                                
                                
                            
                            
                        
                    
                    
                

            
        
        
            
                
                    
                    
                    
                    
                    Medications
                    
                        
                            
                                
                                    Medication
                                    Dosage
                                    Effective Time
                                    Active?
                                
                            
                            
                                
                                    Augmentin 125-31.25 MG CHEW
                                    3 once a week
                                    1/14/2008
                                    Yes
                                
                                
                                    Albuterol Sulfate 108 MCG/ACT AERS
                                    2 Puffs q6hrs prn
                                    1/14/2008
                                    Yes
                                
                                
                            
                            
                        
                    
                    
                        
                        
                        
                            
                            
                            
                            
                            
                            
                                
                                
                            
                            
                                
                                
                            
                            
                            
                                
                            
                            
                                
                                
                            
                            
                                
                                    
                                    
                                    
                                    
                                    
                                        
                                            
                                                
                                            
                                        
                                        This is my name
                                    
                                    
                                
                                
                                
                                
                            
                            
                                
                                    
                                    
                                    
                                    
                                        
                                    
                                    
                                
                            
                            
                            
                        
                        
                    
                    
                

            

            
                
                    
                    
                    
                    
                    Allergies and adverse reactions
                    
                        Penicillin
                    
                    
                        
                            
                            
                            
                            
                            
                            
                            
                                
                                
                            
                            
                            
                                
                                    
                                    
                                    
                                    
                                    
                                        >
Medication	Dosage	Effective Time	Active?
Augmentin 125-31.25 MG CHEW	3 once a week	1/14/2008	Yes
Albuterol Sulfate 108 MCG/ACT AERS	2 Puffs q6hrs prn	1/14/2008	Yes