| |
 |
Demographics |
|
 |
 |
| MRN |
01000575 |
Date of
Birth |
7/7/1977 |
 |
| First
Name |
Mickey |
Age |
26.6 years |
 |
| Last Name |
Mouse |
Blood
Type |
A |
 |
| Address |
2345 Disney Street |
Sex |
M |
 |
| City |
Orlando |
Race |
Caucasian |
 |
| ST,
Zip |
FL, 77878 |
Exit
Date: |
|
 |
|
|
Primary
Disease: |
OTC Deficiency |
 |
| If Waiting for
Transplant, Most Recent PELD
Score: 23 |
 |
| Research Protocols |
 |
Clinical Trials |
 |
|
 |
|
 |
 |
| Care Givers |
 |
Name |
 |
Phone |
 |
| Primary |
 |
Walt Disney |
 |
888-434-7639 |
 |
| Secondary |
 |
Donald Duck |
 |
888-123-4567 |
 | |
 |
|
|