Leave 2 spaces between colon and line

RADIOLOGY REPORT or DIAGNOSTIC IMAGING REPORT

Patient Name:Brenda See Sagermann

Patient ID:903321 DOB:11/25/---- Age:38 Sex:F

Report No.:11-55432

Ordering Physician:Alex McClure

Procedure: transvaginal ultrasound

Date of Procedure:03/27/-----

PATIENT HISTORY:Severe left pelvic pain.Rule out ectopic pregnancy.

Pregnancy test is positive.

FINDINGS:Trans abdominal imaging demonstrates a uterus with a small

amount of fluid within it. There was a pseudo decidual pseudodecidual sign.
there was a large amount of hemorrhage seen within the left adnexa. No
embryo is seen. The right ovary is unremarkable.

Endovaginal examination was performed in search of a viable ectopic when

it's One is seen with a crown-rump-length of 1.3 centimetres cm
corresponding to seven 7-weeks four 4-days( ). A a large amount of free
time fluid is seen as pseudo gestational sac as noted within the uterus which
is oblong.
Page ending is missing

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Heading for Page 2 is missing
impressionIMPRESSION: A left sided ectopic pregnancy is found with a large
amount of hemorrhage noted within the left adnexa and extending into the
cul-de-sac. The hemorrhage measures 13 by x six by x 10 centimetres cm.

Dr. McClure in the emergency room was notified who will notify the surgeon
who was on her way to the hospital.
Do not dictate this part.
Here the Dr. is telling
you that it is the end
End of report by Dr.Donna Harrison. also instructions on
copying another
Send a copy of this report to Rosemary Bumbak ,MD OB/GYN. physician
thanks.

You should end the report with a signature line, the intitials of both the dictating physician and
your initials with both dates of dictation and transcription (see the model report on how these
reports are closed)

©2011 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part,
except for use as permitted in a license distributed with a certain product or service or otherwise on a password-
protected website for classroom use.