Nicholas Pena

 Maple Grove Clinic 
 830 Shane Mall Suite 056
Port George, SC 26470
 Phone: 959-532-9824 Fax: 288-943-2118 
 Transcription 
 PATIENT: 
 Nicholas Pena
 Service ID #: 59536353054
 Referral Q ID: 
 DATE OF BIRTH: 
 03/05/1987 Age: 55 
 date of injury: 11/11/2018
 Service Date: 24/09/2017 
 Dictated By: Dr Mr. Kyle Montgomery, MD 
 Diagnosis: Hemorrhoids 
 Notes: 
 PHYSICIAN PROGRESS REPORT 
 EMPLOYER: Joseph J Albanese Inc 
 date of injury: 11/11/2018 
 Dear Claims Examiner: 
 I personally reviewed the patient's Past Medical, Family, and Social 
 History as reported on the initial visit, and it remains unchanged other 
 than the exceptions otherwise noted. 
 OBJECTIVE FINDINGS: 
 General Appearance: The patient is examined, in no apparent distress. He 
 is alert and oriented x3. He is well-developed and well-nourished male 
 appearing his stated age. 
 Examination of the Lumbosacral Spine: 
 Dictated By: Dr Mr. Kyle Montgomery, MD 
 Dictated On: 7/23/2020 3:36 PM 
