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| Jonah Robbins |
| MRN 830171 |
DOB 7/7/1955 |
Age 70 |
Gender Male |
Ethnicity Alaska Native |
Height 154.9 cm |
Weight 80 kg |
Creatinine 1.6 mg/dL |
| Patient Name: Jonah Robbins DOB: 7/7/1955 Room: 741 |
Allergies: nitrofurantoin (severe rash, angioedema), 3 years ago | Immunization History:
|
| Community Rx Info: Walgreens Rx Insurance: OptumRx |
Social History:
|
Name |
(date/time) |
Effects |
for D,H,M |
||||||
2030 |
|||||||||
0730 |
|||||||||
2300 |
|||||||||
Vitamin C |
0730 |
||||||||
0730 |
|||||||||
| Additional Notes: CrCl = 39 mL/min based on adjusted body weight of 63.4 kg (ABW/IBW = 153%) | Action Key: C = Continue *Must provide reason: D = Discontinue, H = Hold, M = Modify |
| Med history obtained by (sign and print): | Date: 12-16-2025 |
| Patient Name: Jonah Robbins DOB: 7/7/1955 Room: 741 |
Allergies: nitrofurantoin (severe rash, angioedema), 3 years ago | Immunization History:
|
| Community Rx Info: Walgreens Rx Insurance: OptumRx |
Social History:
|
Name |
(date/time) |
Effects |
for D,H,M |
||||||
2030 |
|||||||||
0730 |
|||||||||
2300 |
|||||||||
Vitamin C |
0730 |
||||||||
0730 |
|||||||||
| Additional Notes: | Action Key: C = Continue *Must provide reason: D = Discontinue, H = Hold, M = Modify |
| Med history obtained by (sign and print): | Date: 12-16-2025 |