Date of Birth: December 18, 1957 Gender: Male Ethnicity/Race: Catholic Address: Kalubihan Quiot, Cebu City Contact No: Medical History: ICU Medical Conditions: *Current Medications: Amlodipine, metformin, Aspilets *Family Medical History: High Blood, Diabetic Insurance Provider: Himalayan Insurance Employment: Business Owner Education: Marine Engineering
PATIENT’S MEDICAL HISTORY:
Patient’s Name: Moises Divena Gracia Sr. Age: 64 Gender: Male Date of Birth: December 18, 1957 Marital Status: Married Address: Kalubihan Quiot, Cebu City Contact No: Email: NONE Occupation: Business Owner Insurance: Himalayan Insurance Complaint: Color Blindness, Headache Date of Visit: September 24, 2021 Reason of Visit: Follow up Check up Hospital Visit: Velez Hospital