Face Sheet

Templates

Face Sheet

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Healthcare

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Datapoint

Description

This is some text inside of a div block.

Patient Name

Full legal name of the patient receiving care.

Date of Birth (DOB)

Birthdate used to verify identity and calculate age.

Sex / Gender

Patient’s sex or gender designation as recorded.

Medical Record Number (MRN)

Unique patient identifier within the hospital system.

Social Security Number (SSN)

Used for billing, identity verification, and insurance purposes (if collected).

Marital Status

Patient's marital status (e.g., single, married, divorced).

Primary Language

Language primarily spoken by the patient.

Race / Ethnicity

Self-reported or observed demographic classification.

Phone Number(s)

Primary and secondary contact numbers.

Address

Full residential address of the patient.

Emergency Contact Name

Full name of the designated emergency contact.

Relationship to Patient

Describes how the contact is related to the patient (e.g., spouse, parent).

Emergency Contact Phone Number

Primary number to reach the contact in case of emergency.

Primary Insurance Carrier

Name of the main health insurance provider.

Secondary Insurance Carrier

Additional insurance provider, if applicable.

Policy Number / Group Number

Identifiers used for billing and coverage verification.

Subscriber Name & DOB

Information about the primary policyholder (may differ from the patient).

Coverage Type

Specifies HMO, PPO, Medicare, Medicaid, etc.

Admitting Diagnosis

Initial diagnosis or reason for hospitalization.

Principal Diagnosis

Primary condition being treated, often coded (e.g., ICD-10).

Allergies

Documented allergies to medications, food, or substances.

Medications

List of current prescriptions or treatments at time of admission.

Primary Care Physician (PCP)

Doctor responsible for overseeing patient’s general medical care.

Attending Physician

Doctor overseeing the patient's care during the hospital stay.

Hospital Service / Unit

Indicates where the patient is receiving care (e.g., ICU, Med-Surg).

Admission Date / Time

When the patient was admitted to the facility.

Discharge Date / Time

(if discharged) Date and time of patient release from care.

Face sheets provide core patient demographic, contact, and insurance information essential for admission, billing, and care coordination. Feathery’s AI extraction engine captures the patient’s full legal name, date of birth, sex or gender, medical record number, Social Security number, marital status, primary language, race or ethnicity, phone numbers, and residential address. Emergency contact details, including name, relationship to the patient, and phone number, are also extracted for quick reference.

The engine further retrieves primary and secondary insurance carrier information to streamline eligibility checks and billing processes. This template is ideal for hospitals, clinics, and healthcare administrators seeking to automate patient intake, reduce manual data entry, and improve the accuracy of records across EHR and billing systems.

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