Documents tagged "Patient Information"
Found 4 documents with this tag
DOJ-OGR-00026332.jpg
The image displays a document with multiple columns of text information on a white background. The document appears to be a form or report with headings and various fields filled out. There is visible text including words such as "Date," "Name," "Address," "Phone Number," "Email Address," and sections labeled "Patient Information," "Medical History," and others that are not fully legible due to the resolution of the image. The document seems to be a medical or healthcare-related form, given the context of patient information typically requested in such documents.
DOJ-OGR-00026276.jpg
The image appears to be a photograph of a document, possibly from an official report or medical record. The text is blurred and not clearly legible, but there are sections with headings such as "Patient Information" at the top and what seems like a "Clinical Summary" towards the bottom. There are checkboxes with yes/no options next to various statements which could be health-related questions or conditions for assessment. A handwritten note in red ink is visible, highlighting an area on the document with a question mark, indicating some level of concern or query regarding that section. The overall style of the image suggests it might have been taken quickly, possibly for the purpose of sharing the highlighted portion of the document.
DOJ-OGR-00026088.jpg
The image displays a document titled "BOARD OF PRISONERS" at the top. The body of the text is too small to read clearly; however, it appears to contain details and information pertaining to prisoners or inmate situations within an institution. There are various sections with headings such as "Patient Information," "Administrative Remarks," and a series of fields that likely include dates, names, and notes. The text is printed on what seems to be a standard piece of paper, possibly used for official documentation within a correctional facility or similar institution. There are no visible people, locations, or significant objects other than the document itself in this image.
DOJ-OGR-00025393.jpg
The image shows a blurred document with several sections and checkboxes. At the top, there's visible text that includes "Patient Information" followed by a section titled "Reason for Visit" with multiple options listed but not fully legible due to the resolution of the photo. There are also lines underlined with red pen markings, highlighting certain areas of the form. The document appears to be an official medical or health-related paper that is used in clinical settings for patient assessment and data collection.