{{demographics.name|full_name}}

{{demographics.name|display_name}} is a {% if demographics.dob %}{{demographics.dob|age}} year old{% endif %} {% if demographics.race %}{{demographics.race}} {% endif %}{% if demographics.marital_status %}{{demographics.marital_status|lower}} {% endif %}{{demographics.gender|lower}} {% if demographics.religion or demographics.language %}who {% if demographics.religion %}is {{demographics.religion}}{% if demographics.language %} and {% endif %}{% endif %}{% if demographics.language %}speaks {{demographics.language|isolanguage|title}}{% endif %}{% endif %}. {{demographics.gender|gender_pronoun|title}} has {{allergies|max_severity}} allergies. In the past year, {{demographics.gender|gender_pronoun}} {% if encounters|since_days(365)|strict_length == 0 %} did not have medical encounters {% else %} had medical encounters {% endif %} and has {% if medications|since_days(365)|strict_length == 0 %} not had any medications prescribed. {% else %} been prescribed medications. {% endif %}

Birthday

{{demographics.dob|date("F j, Y")}}

Address

{% if demographics.address.street|length == 2 %} {% for line in demographics.address.street %}

{{line}}

{% endfor %} {% else %}

{{demographics.address.street}}

{% endif %}

{{demographics.address.city}}, {{demographics.address.state}} {{demographics.address.zip}}

Telephone

{% for number in demographics.phone %} {% if number %}

{{loop.key|slice(0,1)}}: {{number|format_phone}}

{% endif %} {% else %}

No known number

{% endfor %}

{% if demographics.guardian and demographics.guardian.name.family %}

{{demographics.guardian.relationship|fallback("Guardian")}}

{{demographics.guardian.name|full_name}}

{% for number in demographics.guardian.phone %} {% if number %}

{{loop.key|slice(0,1)}}: {{number|format_phone}}

{% endif %} {% else %}

No known number

{% endfor %}

{% endif %}

Allergies

{% for allergy in allergies %} {% if loop.first %}

{% endif %}

• {{allergy.allergen.name}}

  {% if allergy.severity %}

  {{allergy.severity}}

  {% endif %} {% if allergy.reaction.name %}

  Causes {{allergy.reaction.name|lower}}

  {% endif %}
{% if loop.last %}

{% endif %} {% else %}

No known allergies

{% endfor %}

Medication History

{% for med in medications %} {% if loop.first %}

{% endif %}

• {{med.product.name}}

  {% if med.administration.name %}{{med.administration.name|title}}{% endif %} {% if med.reason.name %}for {{med.reason.name}}{% endif %}

  {% if med.prescriber.organization or med.prescriber.person %}

  Prescriber

  {% if med.prescriber.organization %}

  {{med.prescriber.organization}}

  {% endif %} {% if med.prescriber.person %}

  {{med.prescriber.person}}

  {% endif %}

  {% endif %} {% if med.date_range.start or med.date_range.end %}

  Date

  {% if med.date_range.start %}{{med.date_range.start|date('M j, Y')}}{% endif %} {% if med.date_range.end %}– {{med.date_range.end|date('M j, Y')}}{% endif %}

  {% endif %}

{% if loop.last %}

{% endif %} {% else %}

No known medications

{% endfor %}

Immunizations

{% for group in immunizations|group('product.name') %} {% if loop.first %}

{% endif %}

• {{group.grouper}}

  {% for item in group.list %} {% if loop.first %}
  {% endif %}
  • {{item.date|date('M j, Y')}}
  {% if loop.last %}
  {% endif %} {% endfor %}
{% if loop.last %}

{% endif %} {% else %}

No known immunizations

{% endfor %}

Medical History

{% for encounter in encounters %} {% if loop.first %}

{% endif %}

• {{encounter.date|date('M j, Y')}}

  Encounter

  {{encounter.name|fallback("Unknown Visit")|title}}

  {% if encounter.finding.name %}

  Finding: {{encounter.finding.name}}

  {% endif %}

  {% for problem in encounter|related_by_date('problems') %}

  Problem

  {{problem.name}}

  {% endfor %} {% for procedure in encounter|related_by_date('procedures') %}

  Procedure

  {{procedure.name}}

  {% endfor %} {% for medication in encounter|related_by_date('medications') %}

  Medication

  {{medication.product.name}}

  {% endfor %} {% for immunization in encounter|related_by_date('immunizations') %}

  Immunization

  {{immunization.product.name}}

  {% endfor %}

{% if loop.last %}

{% endif %} {% else %}

No known past encounters

{% endfor %}

Lab Results

{% for panel in labs %} {% if loop.first %}

{% endif %}

• {{panel.results[0].date|date('M j, Y')}} {{panel.name|fallback("Laboratory Panel")}}

  • Component Value Low High
  {% for result in panel.results %}
  • {{result.name}} {{result.value|fallback("Unknown")}}{% if result.unit %} {{result.unit|format_unit|raw}}{% endif %} {% if result.reference.low %}{{result.reference.low}}{% endif %} {% if result.reference.high %}{{result.reference.high}}{% endif %}
  {% endfor %}
{% if loop.last %}

{% endif %} {% endfor %}