Documents tagged "patient"

Found 34 documents with this tag

EFTA00005569-p-6.jpg

The image shows a printed document with multiple sections of text and fields filled out. The top section appears to be titled "Photo Lab Print Release," followed by a date that is partially obscured (starting with "07/30/96"). There are two blacked-out names in the first field labeled "Patient Name." Each subsequent section has similar fields such as "Photographer," "Print Number," "Medical Record," and others that are also filled out with either blacked-out information or actual data like dates and initials. The document is secured by a binder clip on the left side, indicating it's meant to be part of an organized collection or file.

Photo Lab Print Release Patient Name Print Number Medical Record Lab Print Release Patient Name Photographer Number Medical Record form id Photo Lab Print Release,07/30/96 Patient Name.Photographer,Print Number,

EFTA00005386-p-017.jpg

The image shows a collection of photographs pasted together on what appears to be an index card with the label "EXAMINATION" at the top left corner. The style of the images suggests they are from a medical context, possibly for educational purposes or patient evaluation. There is visible text in the bottom right area of the image that includes the words "GALL BLADDER" and "LAPAROSCOPY." The photographs depict various surgical scenes involving the gallbladder, specifically laparoscopic procedures, with some areas obscured by black tape to preserve patient privacy.

medical EXAMINATION GALL BLADDER LAPAROSCOPY.photographs patient collection pasted together index label corner style

EFTA00001864-p-1.jpg

The image shows an interior view of a dental office. In the foreground, there's a dental chair with equipment attached to it, likely for patient care and examination. The walls are painted light colors, and on one wall hangs a framed picture, though its content is not clear from this angle. There's a closed white door visible in the background, providing an exit or entrance to the room. The floor appears to be wooden with a dark finish. There's no text visible in the image, and there are no people present.

id dental visible interior office foreground chair equipment attached likely patient

DOJ-OGR-00006583.jpg

The image shows a printed document with text on it. The top part of the text is partially obscured, but what can be seen includes phrases such as "Request for" and "Laboratory Services" along with a file date in blue text that reads "08-26-97." Below this header, there are lines where information should be filled out, including sections titled "Patient Name," "Address," and "Phone Number." The document appears to be related to medical or healthcare services due to the context of its purpose. The style of the image is a simple photograph capturing the printed page without any additional embellishments or decorations.

Laboratory Services Patient Name Phone Number Request Laboratory Services Below Patient Name Address Phone Number

DOJ-OGR-00026764.jpg

The image appears to be a digital photograph of printed material with a focus on a document or form. The text within the document is partially obscured and not entirely legible due to the quality of the photo and the angle at which it was taken. However, certain words are discernable, such as "Observation Record" and "Mental Health Care Act." There's also mention of a "Patient's Name" field followed by "Signature" for a witness. The document seems to be related to health care or medical observation records, possibly within the context of mental health treatment.

Observation Record Mental Health Care Act However Observation Record Mental Health Care Act Patient Name Signature

DOJ-OGR-00026684.jpg

The image shows three pieces of paper taped together on a wall. The topmost document is titled "MEMORIAL HOSPITAL" and includes sections with headings such as "Patient's Name," "Admission Date," and "Discharge Date," all of which are blank. Below that, there's another piece of paper with a section headed "EMPLOYEE NAME" followed by a date. The third document has the words "WARD 307 - MALE" at the top. There is handwritten text on the second and third papers, but the content is not clear in the image. The style of the documents suggests they are official hospital records.

Admission Date Discharge Date Patient Name Admission Date Discharge Below

DOJ-OGR-00026681.jpg

The image shows a printed document with two sections, each containing different information. The top section appears to be a form with various fields such as "Payer Name" and "Patient ID" which are typically associated with medical billing or insurance forms. Below this is a barcode that could possibly be used for scanning purposes in an office setting. The bottom section includes handwritten notes, although the exact content of the writing is not clear due to the image's quality. The background is nondescript and doesn't provide any additional context about the location or setting where this document was found.

Payer Name Payer Name Patient Below

DOJ-OGR-00026460.jpg

The image appears to be a printed document with handwritten annotations. It features a table titled "EMTALA GUIDELINES" and includes columns labeled "Patient's Name," "Date/Time of Presentation," "Triage Time (15 Min.)," "Physician Exam Time (30 Min.)," and other medical evaluation times. The table lists patient names, dates, and time intervals associated with each step of the process. In addition to the printed content, there are several handwritten marks and notes on the document, including some highlighted areas, underlined text, and circled numbers or terms. The annotations suggest that someone has reviewed the information closely, possibly for quality assurance or instructional purposes.

Triage Time Physician Exam Time Patient Name Date Time Presentation Triage Min Physician Exam

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.

Phone Number Email Address Patient Information Medical History Date Name Address Phone Number Email Patient Information Medical History

DOJ-OGR-00026318.jpg

The image is of a document with printed text, which appears to be an official form or letter from a medical institution. At the top, there's a section with handwritten notes and marks, suggesting annotations or corrections have been made. The visible portions of the text include phrases such as "Patient Name," "Address," and "Phone," indicating fields for personal information about the patient. There is also some reference to medical terms like "Health Care Provider," "Appointment Date," and "Time," which suggest that this form is related to scheduling or keeping track of appointments within a health care context.

Patient Name Health Care Provider Appointment Date Patient Name Address Phone Health Care Provider Appointment Date Time

DOJ-OGR-00026287.jpg

The image shows a printed form with various fields and headings. At the top of the form is the title "Prisoners Health Services" followed by what appears to be an identification number in pink ink. There are sections titled "Patient Name," which is currently blank, "Medical Number," again left empty, and other areas such as "Date of Birth," "Address," and "Phone Number." Each section seems to be intended for specific personal information about the individual receiving healthcare services. The form has a structured layout with lines dividing different fields, suggesting it's designed to collect essential demographic and contact details.

Prisoners Health Services Patient Name Medical Number Phone Number Prisoners Health Services Patient Name Medical Number Date Birth Address Phone

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.

Patient Information Clinical Summary Patient Information Clinical Summary

DOJ-OGR-00026274.jpg

The image is a blurry photograph of a printed document. The text on the document is partially obscured and not fully legible due to the focus and resolution of the photo. However, it appears to be an informational sheet with various sections such as "Patient Name," "Medications," and possibly additional details like dates or notes. There are some visible words and numbers that suggest a medical context, but their specific meanings are not clear in this image. The overall quality of the photograph makes it difficult to provide detailed information about the document's content.

Patient Name However Patient Name Medications

DOJ-OGR-00026247.jpg

The image shows a document with a section titled "Information for Patient Services." It contains checkboxes next to phrases such as "New patient visit," "Established patient office visit," and others related to healthcare services. There are placeholders for the patient's name, diagnosis or reason for visit, and billing information. The document appears to be a form used in a medical setting for appointment scheduling or record-keeping purposes.

Patient Services Information Patient Services New Established

DOJ-OGR-00026244.jpg

The image shows a printed document with various columns of information. At the top left corner, there's a header that includes numbers and possibly reference codes. There are several entries under different categories such as "Date," "Time," "Location," "Patient Name," and "Medical Problem." Some of these fields have data entered into them, while others appear to be blank or marked with an "N/A." The document appears to be a medical record sheet used for tracking patient information during hospital visits or treatments.

Patient Name Medical Problem Date Time Location Patient Name Medical Problem

DOJ-OGR-00026217.jpg

The image is a scanned document titled "Bureau of Prisons Clinical Encounter Administrative Note" with the date stamp reading April 2017. The document appears to be a form intended for medical-related interactions within the Bureau of Prisons, possibly in the United States. There are sections labeled "Patient Name," "Visit Date," and other fields that would likely contain information about the patient's visit, although the specific details are redacted or not filled out on this particular form. A signature is visible at the bottom right corner of the document, but the name associated with it is not legible in this image. The style of the document suggests a standard administrative format typically used by governmental agencies for tracking medical encounters within their jurisdiction.

Prisons Clinical Encounter Administrative United States Patient Name Visit Date Bureau Prisons Clinical Encounter Administrative Note April United States Patient Name Visit Date

DOJ-OGR-00026166.jpg

The image appears to be a document, possibly an itemized receipt, report, or list from a pharmacy or medical facility. It contains various fields of data including date and time stamps at the top. There is printed text with information such as "RX #" followed by a number, "Patient's Name," which is likely where the patient's name would be listed, and other fields like "Prescriber's Name," "Quantity," and "Amount Due." The specific details in these fields are not visible in this description. There are also numerical amounts and codes under some headings, which are common elements of medical billing or prescription records to denote medication names, dosage forms, and costs.

Amount Due Patient Name Prescriber Quantity Amount Due

DOJ-OGR-00026164.jpg

The image displays a medical document with a header that reads "Patient Summary" at the top. Below the header, there is a series of sections with headings such as "Date of Birth," "Primary Care Provider," and other medical information fields. The document appears to be a template for recording various details about a patient's health history or status, although specific data has been redacted to maintain privacy. The style of the image is straightforward and informational, typical of medical records or administrative forms used in healthcare settings.

Patient Summary Primary Care Provider Patient Summary Below Date Birth Primary Care Provider

DOJ-OGR-00026154.jpg

The image shows a document titled "Department of Corrections Medication Request" at the top left corner. It is a form that includes several checkboxes and lines for information entry. There are two visible sections with checkmarks: one labeled "New Prescription" and another labeled "Change in Dosage/Frequency." At the bottom right, there's a signature within a box labeled "Signature of Patient or Legal Guardian." The form also includes spaces for date and time, but these are not filled out. There is no text indicating people or locations, and the document itself appears to be a standard office paper with visible creases and folds.

Corrections Medication Request New Prescription Legal Guardian Department Corrections Medication Request New Prescription Change Dosage Frequency Signature Patient Legal Guardian

DOJ-OGR-00026133.jpg

The image appears to be a photograph of printed material, specifically a form with various lines and sections filled out. The top part of the form includes what seems to be a title followed by checkboxes and possibly dates, although the text is partially obscured. Further down, there are sections where handwritten information has been provided; these include words like "Patient", "Staff", "Physician", and other terms that suggest medical context. There are also checkboxes with marks next to them, indicating selections made by a person filling out the form. The overall quality of the image is low resolution, making it difficult to read all the text clearly or discern specific details about the location or significance of the objects.

Further Patient Staff Physician

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