Mr. Zachary Terry
Age: 62
Patient ID: 16692
Demographics
Sex: Other
Height: 5.7
Weight: 195
Blood Type: A
Provider & Insurance
Primary Care: Dr. Jane Smith
Insurance: BlueCross BlueShield
Policy Number: 123456789
Insurance Contact: (555) 123-4567
Medical Summary
Allergies: Penicillin, Peanuts
Active Conditions: Hypertension, Asthma
Medications: Lisinopril, Albuterol
Last Visit: Jan 15, 2025
Care Plan & Appointments
Current Care Plan: Physical Therapy for ACL Recovery
Next Appointment: Feb 20, 2025
Assigned Care Team: Dr. John Doe, PT Specialist
Last Procedure: Knee Arthroscopy - Dec 5, 2024
Patient Information
First Name
Mr. Zachary Terry
Last Name
Doe
Date of Birth
1963-06-10
Gender
Other
Phone Number
(721) 240-1160
Insurance Provider
Leuschke, Spencer and Waters
Patient ID
16692
Emergency Contact
Jane Doe (+1 987 654 3210)
Patient Address
Street Address
123 Main St, Apt 4B
City
Denver
State/Province
Colorado
Zip Code
80202
Country
United States
Emergency Contact Address
456 Elm St, Apt 10C, Denver, CO