Good Health Clinic Continuity of Care Document Created On: January 6, 2012 Patient MRN Table of Contents Henry Levin , the 7th 996-756-495 Birthdate Sex September 24, 1932 Male Guardian Next of Kin Kenneth Ross Henrietta Levin 17 Daws Rd. tel:(999)555-1212 Blue Bell, MA, 02368 Purpose Transfer of care Payers
Good Health Clinic Continuity of Care Document Created On: January 6, 2012 Patient Henry Levin , the 7th Birthdate September 24, 1932 Guardian Kenneth Ross 17 Daws Rd. Blue Bell, MA, 02368 MRN 996-756-495 Sex Male Next of Kin Henrietta Levin tel:(999)555-1212 Table of Contents Purpose Transfer of care Payers
Netsmart_Behavioral_Health_CCD.docx