Fernando Jakubowski
Age: 50
Patient ID: 17755
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
Fernando Jakubowski
Last Name
Doe
Date of Birth
1975-08-12
Gender
Other
Phone Number
(893) 440-3205
Insurance Provider
Cruickshank Group
Patient ID
17755
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