(For teaching purposes ONLY.

)
Maritime Hospitals Trust
Anson Hospital, Tel.: 01634 8843618

Notification and Summary of Discharge

Page 1 of 2

NOTE: Copy 1 to be sent to GP, copy 2 MUST be attached to the drug chart, copy 3 to be handed to the patient

Dear Dr Shah
GPs ADDRESS
Manor House
Newtown
WARD
Female Medical
CONSULTANT Patel

UNIT No. 441030

NAME Greta Fearall
DATE OF BIRTH 30 October 1944
ADDRESS The Palings, Newtown

ADMITTED ON

DISCHARGED ON 29.10.10

19.10.10

DISCHARGED TO
HOME

HOME WITH CARE PACKAGE

HOME WITH COMMUNITY NURSING

* Specify here

1/12

FOLLOW UP DATE
Diagnosis:

* If discharged to one of these please state details

* Nursing home
Residential care home

Gastritis with haematemesis and malaena, atrial flutter with LVF

Gastroscopy 3 gastric ulcers
UE Na 139 K 5.5 Cr 268
Digoxin 1.7
ECG shows atrial flutter, Rx Amiodarone initiated

Investigations & management summary:

Hb 12.3
Allergies: NKDA
Pharmacy
use only

Date
Prescribed

DRUG (in CAPITALS)

Route

Dose and
Frequency

Duration

Doctors
signature

29.10.10
29.10.10
29.10.10

Furosemide
Omeprazole
Digoxin

po
po
po

40mg bd
20mg od

AK
AK
AK

29.10.10

Glyceryl trinitrate
spray
Amiodarone

s/l

125 g od
1-2 sprays prn

1/12
1/12
1/12
1/12

AK

po

200mg od

1/12

AK

29.10.10
Yours sincerely AK

Medical Officers Name and Grade

Medical Officers Signature

(CAPITALS)

AK Bleep 47

AK

FY1

Full summary to follow

No