Referral Summary EFC0152F-6BB5-4369-8530-BBE90384F783 (Buderim GE Centre Demo)

Miss Sally GRANT							Born 21-Aug-1957 (60y) Gender Female
Address 135 Long Way HATFIELD NSW 2715							Phone 61(04)38183159	Medicare No 3501803154
Specimen		Lab No 38923D2B-201F-4DB1-9250-BA8D3C4F84F0			Request Date 8/6/2017		Effective Date 8/6/2017			Generated Date 8/6/2017 22:36

Provider	Role	Address
Associated Providers
Dr ANDREW K MCINTYRE	Consulting Provider	102 Wises Road MAROOCHYDORE QLD 4558
Mr. JARED DAVISON	Referred to Provider	139 King Street BUDERIM QLD 4556

Substance	Reaction Type	Severity	Reaction(s)	Date
Allergies
Egg (yolk and white) allergen diagnostic allergen extract	Food allergy	Mild	swollen throat and mouth	9/6/2004
Nuts and seeds	Food allergy
Penicillins	Drug allergy
Dust	Environmental Allergy	Severe	acute asmtha	8/6/2005
Cat dander	Animal Allergy
Eucalyptus pollen	Pollen Allergy
Soy protein	Food allergy
Chicken - meat	Food allergy
Latex	Miscellaneous allergy	Unknown	minor skin irritation at site of contact	3/1/2007

Drug	Dose	Frequency	Route	Start Date
Current Medications
Beconase Allergy & Hayfever 12 Hour 50 mcg/ dose Nasal spray 200 doses	2	BID	Nasal	6/6/2017
Nexium 20 mg Tablets	20 mg	mane	Oral	6/6/2017
Eleanor 150/30 ED Tablets	1	mane	Oral	6/6/2017
Seretide Accuhaler (250/50) Powder for inhalation 60 doses	2	BID	Inhalation	1/3/2017
Afluria Quad Suspension for injection 0.5 mL	1	prn	Intra-arterial	6/6/2017
Asmol CFC-free Inhaler 100 mcg/ dose 200 doses	2	prn	Inhalation	7/6/2017

Referral Summary

Chief Complaint	Date of Onset
History of Presenting Complaint
Toxic encephalopathy due to mercury	29-May-17
headache mad behaviour

Past Illness	Notes	Date
History of Past Illness
Viral hepatitis C		Start Date: 07-Jan-09
Influenza		31-Jan-17 till 18-Mar-17

Procedure performed	Notes	Date
Procedures
Bronchoscopy		15-Mar-17
Colonoscopy		04-Jan-17

Gravida	Parity	Miscarriages	Terminations
Pregnancy History
1		2	1

Use and Exposure	Consumption	Lifetime Intake	Date Ceased
Smoking History
Smoker	3 cig/d	20 pack years

Description	Value
Alcohol Intake
Alcohol Intake	Current Drinker
Last Drank Alcohol
Max Daily Standard Drinks	0
Average Daily Alcohol Intake	0.6 std drinks/d
Years Alcohol Consumed	23
Abuse Or Dependence	True
Number of days alcohol consumed (last 30 days)	19
Standard drinks per day on a drinking day (last 30 days)	1

Drug Misuse Details
Other substance Use
Amphetamine misuse
Cannabis misuse

Currently Exercising	Exercise Type	Time Spent Exercising
Exercise History
Gets little exercise		0.5 hrs/week

Description	Recorded Values	Date
Vitals
Blood Pressure	160/90 (Sitting)	07-Jun-17 2:49:00 pm
Pulse rate	70bpm	07-Jun-17 2:49:00 pm
Height/Weight	Height: 100cm Weight: 168.0kg BMI: 168.00	07-Jun-17

Service Provider: Buderim GE Centre Demo

Drug	Dose	Frequency	Route	Start Date	End Date
Past Medications
Pulmicort 200 mcg/ dose Turbuhaler 200 dose	2	BID	Inhalation	13/9/2012	1/6/2016
Ventolin CFC-free Inhaler 100 mcg/ dose 200 doses	2	BID	Inhalation	8/6/2012	13/9/2012