Transcribed Medical Transcription Sample Reports and Examples
MT HelpLine Transcribed Medical Transcription Sample Reports and Examples
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as on 3/19/2014

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Sample Type / Medical Specialty: Pediatrics - Neonatal

The medical practice that deals with the development, care and diseases of children. Refers to specialists for additional care when appropriate.

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Otitis Media - Discharge Summary
Fever, otitis media, and possible sepsis.

Otitis Media - H&P
A 3-year-old female for evaluation of chronic ear infections bilateral - OM (otitis media), suppurative without spontaneous rupture. Adenoid hyperplasia bilateral.

Patent Ductus Arteriosus Ligation
Ligation (clip interruption) of patent ductus arteriosus. This premature baby with operative weight of 600 grams and evidence of persistent pulmonary over circulation and failure to thrive has been diagnosed with a large patent ductus arteriosus originating in the left-sided aortic arch.

Pediatric - Letter
9-month-old male product of a twin gestation complicated by some very mild prematurity having problems with wheezing, cough and shortness of breath over the last several months.

Pediatric Rheumatology Consult
A 7-year-old white male started to complain of pain in his fingers, elbows, and neck. This patient may have had reactive arthritis.

Pediatric Urology Letter
He continues to have abdominal pain, and he had a diuretic renal scan, which indicates no evidence of obstruction and good differential function bilaterally.

Prematurity - Discharge Summary
Prematurity, 34 weeks' gestation, now 5 days old, group B streptococcus exposure, but no sepsis, physiologic jaundice, and feeding problem.

Pulmonary Hypertension - Pediatric Consult
Increasing oxygen requirement. Baby boy has significant pulmonary hypertension.

Reactive Airway Disease
A 23-month-old girl has a history of reactive airway disease, is being treated on an outpatient basis for pneumonia, presents with cough and fever.

Rectal Bleeding - 1-year-old
Pediatric Gastroenterology - Rectal Bleeding Consult.

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NOTE: These transcribed medical transcription sample reports and examples are provided by various users and are for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports. These transcribed medical transcription sample reports may include some uncommon or unusual formats; this would be due to the preference of the dictating physician. All names and dates have been changed (or removed) to keep confidentiality. Any resemblance of any type of name or date or place or anything else to real world is purely incidental.
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Transcribed Medical Transcription Sample Reports and Examples