Patient Information
Patients Name: Michael John Doe
Patients Address: 15 Hogan Terrace, Dublin 16
PPSN: 1234567W
Patients Mobile: +353 86 109 8765
Patients DOB: 01/01/1950
Card No: 12345678
Blood Type: A +
EU Health Card: 12345678910
Organ Donation: Yes
Private Health Insurance: VHI – Policy No. 123456789
Sensitive Medical Information
(Password Protected)
9. Medical Reports (Password Protected):
Sample- MPower Reports
10. Patient M.Power daily monitoring system:
https://patientmpower.com/
Tel: +353 1 903 8558
Email: support@patientmpower.com
11. Any Other Relevant Information:
None.
Basic Medical Information
1. Medical Condition:
Double Lung Transplant (2021)
2. Medication:
MUST CARRY MEDICATION /
MEDICAL EQUIPMENT AT ALL TIMES
- Famotidine
- Mycolat
- Caltrate
- Bisoprolol
- Prograf
- Septrin
- Atorvastatin
- Lansoprazole
- Magnesium
- Prednesol
3. Hospital Contact Details:
Mater Hospital-
- Lung Transplant Nurse Specialist
Tel: 01 803 4296 - Heart Transplant Nurse Specialist
Tel: 01 803 2660 - Out of Hours/Weekend/Evenings
Tel: 01 860 7783 or 01 809 7438
Email: pltresults@mater.ie - Dr. Michelle Murray, Consultant Respiratory Physician
Tel: +353 1 863 2606
4. Medicines to be avoided:
Clarithromycin (Klacid)
Erythromycin
Fluconazole (Diflucan)
Ibuprofen (Neurofen)
Mefanamic Acid
Diclofenac
4b. Allergies:
None
5. GP Contact Details:
Dr Doe
Centric Health
Dublin 2
Tel: 01 123 4567
8. Hospitals Attended:
- St Vincents Public
Tel: +353 1 221 4000
Patient No: 5648742 - St Vincents Private
Tel +353 1 263 8000
Patient No: D127954X - St James Public
Tel – +353 1 410 3000
Patient No: 8769254X - St James Private
Tel: +353 1 410 3185
Patient No: LM47820001 - Blackrock Clinic
Tel: +353 1 283 2222
Patient No: 5498 - Mater Hospital
Tel: +353 1 803 2000
Patient No: 457777 - Mater Private Network
Tel: +353 1 885 8888
Patient No: 1010102 - Beacon Hospital
Tel: +353 1 293 6600
Patient No: 748596102030 - Affidea
Tel: +353 1 806 0877
Patient No: 485963 - VHI 350 HealthCare
Tel: +353 1 448 2450
Patient No: YB45126B