{"text":"CLINICAL INFORMATION \nPage 2 of 2 \nReason for referral \nCare type requested: Out Patient \nExpected outcome: \nNot Specified \nDescription \nH\/O: depression \nDrug addiction \nSchool problem \nPast medical history - \nHigh and Medium Priority Pre-existing conditions \nBody mass index less than 20 \n| Termination of pregnancy \nLaterality \nDrug name \ntablets \nresistant capsules \nFerrous fumarate 210mg \nMirtazapine 45mg tablets \nOmeprazole 20mg gastro- \nBNF code \n61843020 \n88881020 \n69782020 \nClinical warnings \nLifestyle risks \nExercise status: Enjoys light exercise \nAdditional Clinical information \nHistory of presenting complaint \/ examination findings \/ inv \nPresenting complaint \nMain presenting Complaint: referral requested by hospital \nReason for Referral: \nDear colleagues \nPlease see attached hospital discharge letter, which requests a referral to yourelves, \nMany thanks, Dr Hudson. \nModifier Extension \nmedical \nand suicidal ideation \nCODEINE \nextreme school avoidance \nCurrent medication (Active Repeat medication lls\u00e9ued within the last 12 months) \nFormulation Dosage \nFrequency m Duration \nONE THREE TIMES A 26-Nov- \u2019 \ntablet DAY - 2019 - \ntablet . 1 TABLET ONCE A DAY i 14-Sep- ) \nAT NIGHT - 2017 \n2 CAPSULE ONCE A DAY 26-Jan- \ncapsule UNTIL SCOPE - 2017 - \nSmoking status Alcohol consumption \nNumber per day Units per day \n? (not known) 0 (teetotaller) \nRecent medication (Any medication issued within last 90 days not shown above) \nNo recent medications recorded ) \nestigation resulis \nDate Recorded \nSignature of referring doctor (or other professional) Date \nfile:\/\/\/N:\/PCTI\/Docman7\/Data_S1\/Document\/DMEDOC01\/00003900\/01329398 HTM 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