Christina Meyer

 
 DISCHARGE (to Home) Medication Reconciliation Form 
 CHRISTUS Spohn Hosp South 
 Page: 78 
 Utilize this report for discharges to home, nursing home, or skilled unit in a nursing home 
 Linda Cox 
 Ht: 5 ft 7 in 
 (170.2 cm) 
 Location: AV.MS3A 
 Age/Jex:69/8 
 DOB:12/1993/12 Acct: 
 AV0001605078
 MR# MV00480850 Wt: 203 1b 4 oz 192.19 kg) 
 Room/Ded: AV.302-1 
 Attending Doctor: ASATRIAN, ASMIK MD 
 Status: ADM IN 
 CODED ALLERGIES: NO KNOWN ALLERGY 
 HOME MEDICATIONS 


 Physician Signature: 
 Date: 08/2017/25 Time: 
 
 Printed on 10/05/22 @ 1648. Orders and Changes made after this date and time are not reflected on this document. 
 L 17 # 
 AA 80 
 : 
 76778-3 
 South Texas Bone & Joint - 00378
