Temple University School of Medicine - Skull Yearbook (Philadelphia, PA)

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ADMIS-0125-Q31R) TEMPLE UNIVERSITY HOSPITAL □3 16 87 D2:lD PM (QBPSXP) ADMISSION RECORD FFE-CERTIFICAT ION: I S I X II II IXIiK X I I I I 015976408263 99 M 9EAST 920A I IX IK 8 CLASS OF 1937-PATIENT MS: 0101 33 AGE: 4 X I XXX X X FREUD tSIGMUND MD ADM:D3 26 83 PREVIOUS VISIT NAME: PATIENT ADDRESS:3400 N. BROAD ST. SOCIAL SEC NO:123-45-6789 FC : 99 PH I LA » PA 19140 PHONE:215-221-2000 BIRTHDATE:0 I 01 83r PLACE: OCCUPATION: BOOKWORM EGOCENTRIC BUS.PHONE:215-221-2000 JVLRACH1EVER EMPLOYER: TEMPLE UNIVERSITY MTTTi IC A L SCHOOL EMPLOYER ADDRESS:3400 N. BROAD ST. PHILA, PA. 19140 BILL TO:CLASS OF 1937 PHONE:215-221-2000 ADDRESS:KRESGE CLASSRM ArB.CfD PHILAiPA 19140 PRIMARY INS:HEAL ID GROUP: CLASS OF 1937 GROUP : LOC: INP LAST 4 YRS SECOND I NS:G.S.L. LOC: AT: NORTH PHILADELPHIA ID : GROUP: CLASS OF 1987 GROUP : EMERG. CONI:DR.L.HEN IKOFF PHONE:215-221 -2000 RELATI ON:DEAN ADDRESS:MEDICAL SCHOOL PHILA» PA. 19140 PREV DISCH DATE: MAIDEN NAME: BS BA SMOKE:DURING SEX RACE: RELIG: MOTHER 1ST NAME:NA TURE REF.PHYS: DR.HEN I KOFF MULTIPLE UNKNOWN CONSULT . PHYS: ADMIT DATE:08 26 33 TIME:02:10PM STATE OF ARRIVAL: SANE. FRIGHTENED t INCONTINENT ADMIT CLERK: HUGO SMITHr M.D. ADMIT DIAGNOSIS:MEDICAL EDUCATION ====s===========s=========r===N0TE5 C0MMENTS============================ MINIMUM 16 YEAR EDUCATION AND MCAT PROFICIENCY SCORE CLASS OF 1987-FATIENT 015976408263 ADMISSION RECORD 11