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111 Central Blvd., Apt. 10 Oakland, CA 94606 |
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JANE DOE Mother 09/26/69 02/02/99-06/30/99 Sore
throat, cough with phlegm, abdominal pain, headache, right ear pain,
nausea. 07/01/99-09/30/99 Contact
dermatitis. Lower back and abdominal pain. Abdominal cramps and discomfort
with nausea. Increased gas and burping.
Headache, chills. 09/13/00-09/26/00 Headaches,
dizziness, sniffles, cough, anxiety, worsening neck pain, earache,
Sensations of weight/choking in throat, sensation of pressure/strain
from neck to head, intense pain right side behind ear radiates to
right neck, ringing in head. 04/11/01 Mother
also has rash on body (refer to med rec Andres Duran) |
JOHN DOE Father No symptoms to date |
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CHILDREN |
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MARY DOE 05/10/93 04/23/99-05/05/99 Intermittent nausea,
vomiting, anorexia. 08/26/99-12/21/99 Gastrointestinal
problems, vomiting, anorexia, URI, sore throat, congested nose, lung
rales, cough, unable to void. Pnuemonia, RAD, URI. 03/14/00 AGE,
nausea , vomiting, abdominal pain, fever, gases or burps. 10/16/00-10/18/00 Dizziness
since 05/00. Neck pain, headache, anxiety, sore muscles, sensation
of heavy head. 04/08/02 Nausea,
vomiting, abdominal pain, gastrointestinal activity. 10/16/00 Neck
pain. |
JAMES DOE 11/25/89 02/05/99-05/18/99 Bilateral
otitis media. URI. 09/30/99-10/18/99 Cough.
URI, fever, vomiting, rhinorrhea, decreased appetite, tonsils infected.
08/08/00-09/21/00 Pleuritis
right chest pain, shortness of breath, URI. Stomach pain, diarrhea. 02/05/01-05/23/02 URI,
sore throat, cough, fever. Bilateral otitis media with influenza-like
illness, clinical pneumonia, cough, headache, fever, chills. Anxiety. |
JORGE DOE 01/10/96 05/29/98-06/19/98 Cold, cough, negative for rapid strep. 01/21/99-04/13/99 Diarrhea, vomiting, abdominal pain, decreased appetite, dry lips, jaundiced, night time fever. AGE, diarrhea, fever, vomiting, umbilical and right ear pain. Rhinorrhea, without other URI symptoms. 08/17/99-12/13/99 URI, cough with phlegm, rhinorrhea, fever, sadness, fatigue, infected right ear and tonsils. Negative for rapid strep. 01/25/00-05/08/01 UTI, cough, runny
nose, fever. Allergic rhinitis, infected tonsils, enlarged anterior
cervical nodes. No fever, earache or sore throat. |
JOHN DOE, JR. 05/25/00 07/21/00-11/20/00 Contact
dermatitis, intermittent rash. URI, cough. 03/12/01-06/11/01 URI,
cough, runny nose, fever, decreased appetite, rash on body from cheeks
to legs. Confluent rash on antecubital fossa of right arm. Papular
rash on back. 10/09/01 Diarrhea,
blood in stool, gastrointestinal tract activity, vomiting, runny nose,
less appetite, lab test negative for gastroenteritis. 02/06/02-04/05/02 Diarrhea,
abdominal activity, increased temperature, no decrease in activity.
Bilateral otitis media, cough, fever, eye discharge. |