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PACEMAKER IDENTIFICATION - WALLET CARD ......

Cut this card out and keep in your wallet for use when you are
traveling or away from home. I

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PACEMAKER IDENTIFICATION CARD
Name________________ _
Address ________________
Cit_
y _ _ _ _ State _ _ _ _Zip code _ _ _
Phone Blood Type _ _ _ _ _ _
I'm wearing a pacemaker. In an emergency. contact...
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Doctor
Phone
Address
City State Zip code
Hospital
Hospital Phone
Hospital Address
City State Zip code

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Type of pacemaker_ _ _ _ _ _ _ _ _ _ _ _
_
Type of leads _______________
Manufacturer_ ____________ _
Date of implan.______________
Paced rate _______________
Model _________________
Serial Number ______________

© American Heart Association. Inc.