Health Record

Name: John Date of last record: 12.2.2018

Birth Date: 1.4.1985 Contact number: 412 555 784
Medical ID: 12345678912345 other information:
Comment: Started this sheet in 2015

Known condition or allergies

Name Description Medication Dosage Effect / Side Effects Comments
Hay Fever Sneezing, itching eyes Zyrtec 1/4 of a pill per 24hrs none, works great after 6 months, lost some effect

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Medical visits
Date Why Who Where Tests, Feedback, Prescription Prescription

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Vaccination, Immunization
When What Who Where Comment (side effects, results)

1999 Measles, mumps, and rubella Dr.Alan New-York, Children hospital head some fever after

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You have to put the correct values into this sheet based on your doctor's advice.

Eat healthy, do sport, move a lot, be active, have fun

Don't watch to many violent movies, don't bully or be bad, enjoy life and let others enjoy it, b