"Personal Data" "Name","Birth Date","SS#","Blood","Home Phone","Cell Phone","Work Phone","Address","Town","State","Zip","Printable","Color" "Kent Allard","7/31/1930","835-03-1234","AB-","212-286-2860","718-981-1234","515-243-3273","79 7th Ave.","New York","NY","10011","p","White" "Medications" "Primary Name","Alt Name","Purpose","Dose","Freq","Prescriber","Provider","Printable","Color" "simvastatin","(Zocor)","elevated cholesterol","20mg","Daily","John McIntyre","CVS","p","Red" "Plavix","clopidogrel","coronary artery disease","75 mg","Daily","John McIntyre","Walgreens","p","Red" "metformin-SR","(Glucophage XR)","non-alcoholic fatty liver disease ","850 mg","Daily","Rupert Sayre","CVS","p","Blue" "Advair Diskus","fluticasone propionate","COPD","100 mcg","2 Daily","Rupert Sayre","Walgreens","p","Blue" "Advair Diskus","salmeterol","COPD","50 mcg","2 Daily","Rupert Sayre","Walgreens","p","Blue" "omeprazole","(Prilosec)","ulcers","20 mg","2 Daily","Rupert Sayre","CVS","p","Blue" "amoxicillin","","ulcers","1000 mg","2 Daily","Rupert Sayre","CVS","p","Blue" "Biaxin","clarithromycin","ulcers","500 mg","2 Daily","Rupert Sayre","Walgreens","p","Blue" "sertraline","(Zoloft)","obsessive compulsive disorder","50 mg","Daily","Frasier Crane","CVS","p","Orange" "Thiotimoline","rosacea karlsbadensis","causal disassociation","42 mcg ","As Needed","Sam Beckett","--Unknown--","p","Violet" "Radithor","radium","chronic fatigue","1 vial","Daily","Nick Riviera","(doctor)","p","Green" "Anguis Oleum","panacea","everything","1 bottle","At Night","Nick Riviera","(doctor)","p","Green" "ketoconazole","(Nizoral)","athlete's foot","2% cream","Daily","OTC (Drug)","(not applicable)","p","White" "Doctors" "Name","Specialty","Phone","Address","Town","State","Zip","Other Info","Printable","Color" "John McIntyre","Cardiology","310-369-1000","10201 W. Pico Blvd. Bldg 88, Rm 30","Los Angeles","CA","90035","","p","Red" "Rupert Sayre","General Practice","515-243-3273","4 Times Square","New York","NY","10036","","p","Blue" "Frasier Crane","Psychiatry","212-975-4321","51 W. 52nd St.","New York","NY","10019","","p","Orange" "Sam Beckett","Historic Anomalies","818-777-1000","100 Universal City Plaza","Universal City","CA","91608","","p","Violet" "Nick Riviera","Quack","600-362-8672","123 Fake St.","Springfield","NT","12345","","p","Green" "Peter Venkman","Parapsychology","310-244-4000 ","10202 West Washington Blvd. ","Culver City","CA","90232","","p","White" "Stephen Strange","Neurosurgery","212-576-4000","135 W. 50th Street, 7th Floor ","New York","NY","10020","","p","White" "Heathcliff Huxtable","Dentistry","818-464-9600","16027 Ventura Blvd.","Encino","CA","91436","","p","White" "Alan Harper","Chiropractor","818-954-6000","4000 Warner Blvd.","Burbank","CA","91522","","p","White" "Emergency Contacts" "Name","Relation","Home Phone","Work Phone","Cell Phone","Other Info","Printable","Color" "Margo Lane","Friend","415-955-8269","323-965-7316","","","p","White" "Harry Vincent","Friend","312-649-3523","248-458-7991","","call work # first","p","White" "Pharmacies" "Name","Address","Town","State","Zip","Phone","Fax","Other Info","Printable","Color" "Walgreens","200 Wilmot Rd.","Deerfield","IL","60015","847 940-2500","","for brand names","p","White" "CVS","1 CVS Drive ","Woonsocket","RI","02895","800-746-7287","","for generics","p","White" "Medical History / Conditions" "Type","Common Label","Date","Details","Doctor","Printable","Color" "Curable Illness","Peptic Ulcers","n/a","being treated","Rupert Sayre","p","Blue" "Disease-Chronic","COPD","n/a","being treated","Rupert Sayre","p","Blue" "Disease-Chronic","liver disease","n/a","being treated","Rupert Sayre","p","Blue" "Surgery","Atherosclerosis ","3/17/2004","Angioplasty for blocked LCX","John McIntyre","p","Red" "Implant","Coronary Artery Stent","3/17/2004","Endeavour (Medtronic) in LCX","John McIntyre","p","Red" "Implant","Coronary Artery Stent","5/21/2005","Xience V (Abbot) in LCX","John McIntyre","p","Red" "Chronic Disease","Fatigue","n/a","being treated","Nick Riviera","p","Green" "Family History","Lycanthropy","n/a","(maternal grandfather) monitored by >>","Peter Venkman","p","White" "Transplant","Bibliographic Extension","1/1/1988","ultimately returned to donor ","Stephen Strange","p","White" "Allergy-Enviroment","Photodermatitis","n/a","(generally avoid light to avoid symptoms)","None","p","White" "Insurance Plans" "Type","Company","Plan","Group ID","Personal ID","Cust Phone","Doc Phone","Fax","Other Info","Printable","Color" "Health","Medicare","Parts A & B","","835-03-1234A","800-633-4227","","","","p","White" "Health","Mutual of Omaha","Medigap Plan "C"","793053MC","835-03-1234 01","800-228-7104","800-775-1000","","","p","White" "Prescription","Humana","Preferred Rx PDP","D4375","1234A6789","866-945-4481","800-448-6262","","Medicare Part D","p","White" "Dental","Delta Dental","DeltaCare Individual","27566","314253-6475","800-932-0783","","","","p","White" "Immunization" "Vaccine","Doses Needed","Last Dose #","Dose Date","Other Details","Printable","Color" "Tetanus","1","1","6/8/2009","","p","White" "Shingles","1","1","3/24/2007","Zostavax","p","White" "Influenza","1","1","9/23/2013","AFLURIA","p","White" "Hepatitis B","3","2","9/16/2013","Engenrix-B (1 more needed)","p","White"