Radiology Department University of Cupertino Silicon Valley
California, CA 90024
´referringPhysicianª
Name: ´nameª (´patientIDª)
Birthdate: ´dateOfBirthª
Accession Number: ´accessionNumberª Cupertino, Tuesday, January 16, 2018
Report
´modalityª - ´studyNameª
´dateª
Study performed by: ´performingPhysicianª - ´institutionNameª Indication:
Technique: modality: ´modalityª, number of images: ´numberOfImagesª Quality:
Description: Conclusion:
Sincerely,
´performingPhysicianª