Patient Everywoman, Eve
Patient ID(s) 123453 2.16.840.1.113883.19.5
111-00-1234 2.16.840.1.113883.4.1
Contact info Home:
2222 Home Street
City, State 99999, US
Date of Birth April 20, 1990
Sex Female
Race White
Ethnicity Hispanic or Latino
Primary Information Recipient: Dr. Seven, Henry
Contact info 1002 Healthcare Drive
City, State 99999, US
eICR Identifier: ca316e79-aaf2-4e8c-aa5f-848093bb8bb1



Subject:

Public Health Reporting Communication: one or more conditions are reportable, or may be reportable, to public health.

Summary:

Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient. "Zika virus disease (disorder)" is reportable to "State Department of Health". An initial case report was sent to "State Department of Health". Additional information may be required for this report.

"Zika virus disease (disorder)" for "State Department of Health"

Reporting is required within "24 hours". Reporting to this Public Health Agency is based on "both patient home address and provider facility address".

Additional Resources (Information only):