DISCHARGE SUMMARY FORMAT

DATE OF ADMISSION:  April 26, 2005

DATE OF DISCHARGE:  April 30, 2005

REASON FOR ADMISSION: 

DISCHARGE DIAGNOSES: 

PROCEDURE: 

DISPOSITION:

CONSULTATIONS:

DISCHARGE MEDICATION:

HISTORY AND PHYSICAL:

PAST MEDICAL HISTORY: 

HOSPITAL COURSE:

DISCHARGE INSTRUCTION:

DISCHARGE FOLLOWUP: