Chad Ford

 
 39 
 FAX 
 MRN: 1934636H 
 Chad Ford
 Nassau Unly. Medical 
 Gender: Female 
 Center 
 Age: 23y (1986 January 11) 
 Current Location: 
 Surg-Pediatric Eye Clinic 
 AMB OPHTH New Patient Ophthalmology Visit [Charted Location: Surg-Pediatric Eye 
 Clinic [Service Date: 2018 May 26 1:5, Authored: 07-Apr-22 10:53]- for Visit: 
 7710879X1004010031,
 Notice of Status and Rights Involuntary Admission: 
 Patient's Name: Chad Ford
 MRN: 1910710H 
 Sex: Female 
 dob: 1986 January 11 
 Facility Name: Nassau University Medical Center 
 Date of Admit: 2024 January 22 10:31 
 Date & Time: 2017 January 03 11:01  
 Allergies: 
 Allergy, Intolerance, Adverse Event: 
 Allergies: 
 No Known Allergies: Active 
 HPI: 
 Ophthalmology HPI: 
 Chief Complaint 
 Left ruptured globe 
 Page 1 of 6
