Clinical Summary

Patient Delphine Burwell
Date of birth July 8, 1993
Sex Female
Race
Ethnicity
Contact info Primary Home:
6415 Ravenhollow Court
FITCHBURG, WI 53593, USA
Tel: +1-410-377-2787
Patient IDs IDC2210008 1.2.840.114350.1.13.5325.1.7.3.688884.100
555-55-5555 2.16.840.1.113883.4.1
Document Id c412dec8-bd81-11e6-8704-d2068206269d 1.2.840.114350.1.13.5325.1.7.1.1
Document Created: December 8, 2016, 14:06:11, CST
Performer (primary care physician)
Author Epic - Version 8.4
Contact info

Document maintained by Current Stage 1 Primary <b>
Contact info 124 Ok Corral Avenue
Suite 1704B 250
snakes on a plane
4th Line
MADISON, WI 53719, USA
Tel: +1-608-771-0280

Care Team Information