Personal Health Record
Personal Health Information:
First Name: Kiera
Last Name: Manning
Preferred Name: Kiera
Patient Identifier: FCH206
Gender: F
Date of Birth: 02/04/2000
Blood Type: O+
Last Updated Date: 9/16/2021
Address: 4761 Heavner Avenue
City: Jackson
State: GA
Zip Code: 30233
Emergency Contact:
Full Name: Margo Jennings
Relationship: Friend
Contact Number: 555-0098
Insurance Information:
Insurance Carrier: A1 Insurers
Insurance Plan: Comprehensive Plan
Contact Number: 555-3409
Policy Number: 78145
Group Number: 781
SSN: N/A
Health Information:
Physician Information:
Name: Dr. Judah Hendrix
Designation/Specialty: Trauma Surgeon
Phone: 555-6868
Address: 4861 Rosebud Avenue
City: Jackson
State: GA
Known Medical Conditions:
Obsessive Compulsive Disorder (OCD)
Social Anxiety Disorder (SAD)
Allergies:
Penicillin
Psychiatric Evaluation
Patient Name: Kiera Manning
Date: November 23, 2021
DoB: February 4, 2000
Age: 21
Sex: Female
Gender: She/Her
Contact Number: 555-1309
Email: kieramanning2400@gmail.com
Accompanied By: Margo Jennings
Relationship to Patient: Friend
Emergency Contact Name: Margo Jennings
Phone Number: 555-0098
Patient's Signature: Kiera Manning
Chief Complaint and Duration
Has been dealing with obsessive and suicidal behaviors. Admitted by Margo Jennings.
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Limerence
HorrorAfter a life altering car accident, Kiera Manning develops an obsession with the man who saved her life, Dr. Judah Hendrix. It also doesn't help that she has a brain aneurysm, just waiting to rupture. As her obsession grows, so does her mental insta...
