Dr. John G.M. Robertson BSc, MD, CCFP, FRCS(C), FSOGC
John G. M. Robertson M.D. Inc.
Obstetrician Gynaecologist


45779 Luckakuk Way
Chilliwack, B.C.
V2R 4E8

(604)846-4477
Fax 846-4480

##today##

Dr.##referral_nameF## ##referral_nameL##
##referral_address##

Re:##patient_name##
##addressline##
##phone##(H), ##phone2##(W), ##cel##(Cel)
DOB: ##dob##, PHN: ##hinc##

Dear ##referral_nameF##,

Thank you for referring this pleasant ##age## year old Gravida ##G## Para ##P## Spontaneous Abortion ##SA## Termination of Pregnancy ##TOP## ##gender## who presents with ##cc##. Her last menstrual period was ##LMP## and her due date is ##EDC## based on an early dating ultrasound. She is ##EGA## weeks and * days today. Her blood type is ##BloodType##. Her GBS status is ##GBS##. She reports ##HPI##

PAST MEDICAL HISTORY:Her past medical history includes ##medical_historyS##

MEDICATIONS & ALLERGIES:She uses the following medications - ##druglist_line##. She reports allergies to: ##allergies_des_no_archived##.

ON EXAMINATION: Her reported height is ##HT## cm, her reported weight is ##WT## kg, giving her a BMI of ##BMI## kg/m2. Her blood pressure today was ##BP## . Her head and neck exam is ##HN##, there is no obvious thyroid enlargement or lymphadenopathy of the neck. Her chest is ##CHST##, her cardiovascular exam is ##CVS##, her abdomen is soft. There are no palpable abdominal masses or inguinal lymphadenopathy. Her symphysis fundal height is ##SFH## cm, the fetal heart rate is ##FHR## bpm. Her pelvic exam reveals that ##PELV##. The urine dip showed ##UDPR## protein, ##UDGL## glucose, ##UDBL## blood, and ##UDLE## Leukocytes. I have done a point of care ultrasound today. The baby was vertex/breech. It appears to be (fe)male. The amount of fluid around the baby was adequate. The deepest vertical pocket of amniotic fluid was * cm. The measurements were in keeping with her gestational age. The placenta was not previa. The fetal heart rate was ##FHR## beats per minute (as previously mentioned). Please be aware that a point of care ultrasound does not take the place of a formal ultrasound, and this information should not be used for critical clinical decision making. Any clinical concerns should be followed up with a formal ultrasound. I have added a copy of the report to this letter.



##today##

Re:##patient_name## DOB: ##dobc##


DISCUSSION: This is a ##age##year old Gravida ##G## Para ##P## ##gender## who presents with ##cc##.

Once again, thank you for this kind referral.

Yours Sincerely,
##stamp##
John G.M. Robertson, MD

cc: Maternity

page 2