{"text":"Page 3 of 3 \nCLINICAL INFORMATION \nHistory of presenting complaint \/ examination findings \/ investigation resuits \nPresenting complaint \nMain presenting Complaint: drugs \nReason for referral \nCare type requested: Out Patient \nExpected outcome: Not Specified \nPast medical history \nHigh and Medium Priority Pre-existing conditions \nDescription Laterality Modifier Extension Date Recorded \nBody mass index less than20 - . - \u2018 - 29-Jul-2008 \nTermination of pregnancy - - medical 22-Apr-2006 \nH\/O: depression - - and suicidal ideation 15-Feb-2005 \nDrug addiction - - CODEINE 03-Sep-2002 \nSchool problem - to- extreme school avoidance 01-Jan-1995 \nCurvent medication (Active Repeat medication issued within the last 12 months) \nDrug name \u2019 BNF code Formulation Dosage \nFrequency started Duration \nCrodispersble bkt e wber GTEDSPHOHY o5 \nOneprae DT gm0 apie U UEONER L ST \nRecent medication (Any medi\u00e9ation' issued within last 90 days not shown above) \nDrug name BNF code Formulation Dosage Freguency ggr;_:_g Duration . \no OO s GLSOYENTOTE g \nMirtazapine 45mg tablets 88881020 tablet | I{HEAHBTDISP MONTHLY AT - : \u00e9gbgec' \nClinical warnings Smoklng status Alcohol consumption \nLifestyle risks Number per day Units per day \nExercise status: Not Known \u2018 o ? (not known) ? (not known) . \nAdditional Clinical information \nSignature of referring doctor (or other professional) Date \nfile:\/\/\/N:\/PCTI\/Docman7\/Data_S1\/Document\/DMEDOCO]1 \/00003 900\/01099746.HTM 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