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xxxx China Hospital, Sichuan University
Certificate of state of illness upon discharge

(Retained by patient)Patient’s ID no.:
Register no.: xxxx  Dept.: Medical unit of cardiovascular medicine Bed no.: 020  Admitting date: xxxxx, 2013
Name: xx xxxx   Sex: Male Age: xx years+10 months old          Discharge date: Jun. 21, 2013
Address of work unit of the patient: xxx xxxxx China Pharmaceutical Co., Ltd.
Home address: xxxxxxx, xxx District, Chengdu City
Whether send for pathological examination? :No
Discharge diagnosis: Stage III of atrioventricular block

Sealed by Special Seal for Verification of Medical unit of cardiovascular medicine of West China Hospital

Summary for diagnosis and treatment: The patient was hospitalized due to dizziness for half a month and due to one occurrence of amaurosis. The physical examination showed that the body temperature was 36.5°C, the pulse was 40 times/min, the respiratory rate was 19 times/min and blood pressure was 130/70 mmHg. He was conscious without sickly look, his skin and sclera did no show xanthochromia, and systemically superficial lymph nodes were not swollen, and the jugular vein was normal. His heart border was not enlarged, the heartbeat was regular, and murmur was not heard on any cardiac valve. No abnormality was seen with thorax, and unvoiced sound was heard during percussion of both lungs. The breath sounds from both lungs were clear, and moist rale was not heard. The thorax was normal, and the abdominal contour was soft and normal without tenderness or rebound tenderness and was not palpated with any mass. The liver was not palpated under the rib. The spleen was not palpated under the rib. The kidney was not palpated. No lower extremity was edematous. For auxiliary examination, the electrocardiogram result showed atrioventricular block on stage III. The alanine aminotransferase content was 145 IU/L, the aspartate aminotransferase content was 56 IU/L, the albumin content was 38.5g/L, and the blood routine examination results and blood coagulation were normal. The chest radiograph showed increased lung markings which would be determined in combination with clinical examination. The cardiac size was normal. This patient underwent permanent cardiac pacemaker insertion (DDDR) on xxxxx, 2013, and the operation was smooth. Up to now, his illness was stable, the operative wound was normal, and the patient discharged today.
Advice upon discharge and recommendation:
1. Pay attention to rest so as to avoid cold or strenuous exercise.
2. The sutures should be taken out from wound 9-10 days following operation (the sutures can be taken out at local hospital or at the center for taking out sutures in outpatient service of our hospital)
3. During months 2-3 following operation, the patient shall be followed up at cardiac pacemaker clinic, and if the patient does not feel good, he shall see a doctor in time.
Note: This patient underwent permanent cardiac pacemaker insertion (DDDR) on Jun. 18, 2013.
Signed by medical team leader: xx xxx      Signed by physician in charge: xx xxx
Sealed by Special Seal for Verification of Medical unit of cardiovascular medicine of West China Hospital
Statement:
1. This certificate is not valid until sealed with the official seal of our hospital.
2. Any amendment without sealing with the official seal of our hospital is not valid.
3. This certificate only verifies the state of illness of the patient upon discharge.
4. This certificate shall be safely kept and cannot be made up if lost.