Kaitlyn Francis

 
 Patient: Heather Gutierrez DOB: 93-04-04
 OWENS, Shannon DOB: Nov 17, 1976 (46 yo F) Acc No. 7588xx 
 001 Pines University 
 Angel Rodriguez, MD 
 680N UNIVERSITY DR PEMBROKE PINES, FL  
 Internal Medicine 
 Tel: 855-xx Fax: 877-xxx
 Patient: 
 Heather Gutierrez
 20-07-16 
 DOB: 
 93-04-04, Sex: Female 
 Address: 
 2653 JOHNSON ST, HOLLYWOOD, FL 33xxx-38xx 
 Phone: 
 754-2xx-1xxx 
 Ordered Date: 18-11-11 
 Assessments: 
 Dyspepsia - R10.13 
 Lab: 
 H. pylori Breath Test 
 Fasting: 
 No 
 Specimen: 
 Collection Date: 21-10-06 Time:2:56 PM Source:UP: 
 Clinical Info: 
 Name 
 Value 
 Reference Range 
 H. pylori Breath Test 
 No Specimen Received 
 Request Problem 
 H. pylori Breath Test 
 Negative 
 Negative 
 Result: 
 Received Date: 
 20-07-16
 Notes: 
 Patient Name: Owens, Shannon , DOB: 93-04-04
 OWENS, Shannon DOB:93-04-04 (46 yo F) Acc No. 758856 
 Page 12 of 112
 Document: 2023-09-05-Records 
 Printed: 20-07-16 12:22:11 
 Page 12 of 112
