Wallet-Sized Medical Information Card
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1MEDICAL
INFORMATION
EMERGENCY
CONTACTS
CHRONIC
CONDITIONS
PRESCRIPTION
MEDS
OVER
THE
COUNTER
Keep
this
record
with
you
Indicate
any
ongoing
medical
List
prescription
medications
you
List
your
current
over‐the‐
In
case
of
emergency,
please
at
all
times
concerns
are
currently
taking
counter
medications
contact
Name
Name
Blood
pressure
Med
Dose
Time
Aspirin
Address
Antacids
Phone
Asthma
Allergy
relief
Cold
medicine
Phone
Doctor
Diabetes
Diet
pills
Phone
Laxatives
Heart
disease
Sleep
aid
Doctor
Vitamins
Phone
Cancer
Supplements
Pharmacy
Other
Other
Phone
Other
Phone
In
case
of
emergency,
dial
911
In
case
of
emergency,
dial
911
In
case
of
emergency,
dial
911
In
case
of
emergency,
dial
911
In
case
of
emergency,
dial
911
ALLERGY
RECORD
IMMUNIZATION
RECORD
NOTES
NOTES
Enter
the
date
you
were
last
List
all
allergies
and
your
Add
any
additional
information
Add
any
additional
information
immunized
reaction
here
here
Allergy
Tetanus
Reaction
Flu
Allergy
Reaction
Pneumonia
Allergy
Reaction
Hepatitis
Allergy
Other
Reaction
Allergy
Reaction
In
case
of
emergency,
dial
911
In
case
of
emergency,
dial
911
In
case
of
emergency,
dial
911
In
case
of
emergency,
dial
911
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