Sample Med-eData File
ID
Pet Name
Allergies
Last
Bordetella
Bordetella
Last Rabies
Last Teeth Cleaning
Historical Injuries
Recent Conditions
Recent Surgeries
Primary Color
If Yes,
To What
To What
Muzzle Required?
Client
Number
Number
Last Weight
Is Pet Agressive
If yes, list
type/dosage
type/dosage
Date of Last
Vet Visit
Vet Visit
Vet's Name
Vet's Office
Address
Address
Vet's Phone
Owner's Name
Owner's Email
000000
Markings
Breed
Date/Action
Prognosis/
Comments
Comments
Insurance
Pet Type
Pet Gender
1000100
Dog
Female
White
Light brown at ears
Matty
Labrador
7/19/2006
Estimated Age
5 Yrs.
No
Yes
Peanuts
Reaction
Last
Distemper
Distemper
Last
Deworming
Deworming
8/23/2009
8/10/2008
Date of
Surgery
Surgery
Owner's Phone
Hit by car on 3/19/09. Ligament damage to right hind leg. Cruciate ligament torn.
Dr. Mark Dove
1234 Any Street.
Anytown, Any State USA
Anytown, Any State USA
(123) 456.7890
Yes
AOD5677342
No
12-55674
Required surgey. Tibial plateau leveling osteotomy surgey performed 3/21/2009
Tibial plateau leveling osteotomy surgey performed on right hind leg.
9/22/2010
janedoe@gmail.com
Vomitting and diarrhea
Surgeon
Dr. Tammy Love
Ear infection, slides indicate bacterial and yeast.
Monitor progress, perform ear wash 2 x week.
Birthdate
Spayed/
Neutered
Neutered
Yes
72 lbs.
4/2/2009
Currently On Meds?
No
Last Boarded
Boarding
Location
Location
Date of
Condition
Condition
Condition Diagnosis
Surgery Prognosis
Insurance Co.
Guardian
Policy #
Successful, will require physical therapy.
3/21/2009
8/7/2010
Jane Doe
8/21/2010
(123) 456.7890
see below
9/22/2010
12/24/2010-12/30/2010
Acme Pet Hotel
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