Pt. name:  Dale Mayman                        Admitting Physician:   Dr. S Phillips       
Age: 51                                           DOB: 11/13/xx                             Bed: ER Bed 2
Admitting diagnosis: Confusion bleeding gums
Pt. ID # 542768                                                Med Rec #:  78543
Wt. lbs: 172  kg: 78                 Ht.: 71 inches                                 Race:Caucasian
Major Support:  Wife                                                                      Religion:Not stated

Immunizations: current
Allergies: Ace inhibitors (angioedema)