12/33/33
13:45
#2342343
Patient Name
Location
Referral Called In By
Referring/Attending
Physician
Facility
Physician
Admitted

Comments
Page Sent?

Date
Pending/Admitted

Fax Follow-Ups
2019-02-12
HOEP
11:32
Gen. Order
3627364
Mary Grace Johnson
Las Palmas Medical Center
Room 420
Hospital Family Other
1
1
5555551212
R: Guerra
A: Dr. Orlando Ornelas Gutierrez
Jodi
Catalina
C-Xochitl
E-Manny T.
A-Manny T.
12/12/78
12/12/98
Yoli C.
Admit Time:
21:34
11/11/19
01:40
1/12/19
02:22
Who can we thank for this referral? - Monica Gamboa
How did you hear about HOEP? - Family Member