Demographics
DOB: Aug 22, 2000
Sex: M
Status: active
Email: theog942@gmail.com
Mobile: 9712392868
Home: 9712392868
Department: WEST SALEM
Primary Provider: Emma Stacey
Last Synced: Jun 17, 2026, 2:13 PM
Address: 6575 22nd Ave N, KEIZER, OR, 97303
Allergy (3)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Allergy | Aug 2, 2024 | — | |
| Allergy | May 30, 2016 | — | |
| Allergy | Jan 1, 2015 | — |
Vital (7)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Vital | Mar 5, 2026 | — | |
| Vital | Mar 5, 2026 | — | |
| Vital | Mar 5, 2026 | — | |
| Vital | Mar 5, 2026 | — | |
| Vital | Mar 5, 2026 | — | |
| Vital | Mar 5, 2026 | — | |
| Vital | Mar 5, 2026 | — |
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File: ROSE, Theodore
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