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Hospital Discharge Report

Patient
Name: Boyse, Jana
DOB: 27-DEC-1966 (Age: 59)
Gender: female
ID: 9803-542048-2
Author
dr Gunning, Charles
Hospital Discharge Report
Report Date: 12-DEC-2001
Hospital Admission: --
Hospital Discharge: --

Synthesis

Voluntary surgical sterilization, procedure completed

Hospital course note

Dear colleague, I am writing to inform you regarding your patient, a 58-year-old female who was admitted on 11/12/2001 at her own request for elective surgical sterilization. Pre-operative assessment confirmed she was a suitable candidate for the procedure, with no contraindications identified. Routine pre-operative investigations including blood work and anaesthetic assessment were within acceptable parameters. On 12/12/2001, the patient underwent bilateral tubal ligation under general anaesthesia without intraoperative complications. Post-operative recovery was uneventful, and the patient was discharged home in good condition the same day. She has been counselled regarding the permanent and irreversible nature of the procedure. No further gynaecological follow-up is required from our side. Please arrange routine post-operative review in your practice. Should any concerns arise, do not hesitate to contact our department.

Diagnosis at Discharge

Sterilization admitted 12-Dec-2001 active

    Significant procedures

    Bilateral tubal ligation 12-Dec-2001 -