CA2361114A1 - Health and immunization record booklet - Google Patents

Health and immunization record booklet Download PDF

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Publication number
CA2361114A1
CA2361114A1 CA002361114A CA2361114A CA2361114A1 CA 2361114 A1 CA2361114 A1 CA 2361114A1 CA 002361114 A CA002361114 A CA 002361114A CA 2361114 A CA2361114 A CA 2361114A CA 2361114 A1 CA2361114 A1 CA 2361114A1
Authority
CA
Canada
Prior art keywords
pages
health
booklet
immunization
person
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002361114A
Other languages
French (fr)
Inventor
James R. Jinright
Kenneth R. Burton, Jr.
Scott E. Lackey
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MEDICAL DOCUMENTS INTERNATIONAL Inc
Original Assignee
MEDICAL DOCUMENTS INTERNATIONAL, INC.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by MEDICAL DOCUMENTS INTERNATIONAL, INC. filed Critical MEDICAL DOCUMENTS INTERNATIONAL, INC.
Publication of CA2361114A1 publication Critical patent/CA2361114A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • BPERFORMING OPERATIONS; TRANSPORTING
    • B42BOOKBINDING; ALBUMS; FILES; SPECIAL PRINTED MATTER
    • B42DBOOKS; BOOK COVERS; LOOSE LEAVES; PRINTED MATTER CHARACTERISED BY IDENTIFICATION OR SECURITY FEATURES; PRINTED MATTER OF SPECIAL FORMAT OR STYLE NOT OTHERWISE PROVIDED FOR; DEVICES FOR USE THEREWITH AND NOT OTHERWISE PROVIDED FOR; MOVABLE-STRIP WRITING OR READING APPARATUS
    • B42D15/00Printed matter of special format or style not otherwise provided for
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S283/00Printed matter
    • Y10S283/90Medical record
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S428/00Stock material or miscellaneous articles
    • Y10S428/913Material designed to be responsive to temperature, light, moisture

Abstract

A pocket size booklet for keeping statical records of a particular person from birth and for keeping records of an adult person. Non-tearing waterproof pages made from a synthetic material are used, and the data is printed, or data is written, on the pages with an indelible ink. The pages include a water mark on each page.
Pages may include medical history, physical conditions, surgeries, medications, and vaccination records of a person or child. Pages may be provide on which to place the footprints and fingerprints of a new born child.

Description

HEALTH AND IN~JNIZATION RECORD BOOKLET
FIELD OF THE INVENTION
The invention relates to records documents, and more particularly to a records document booklet for health and immunization data, the booklet having water proof pages on which the data is transcribed in indelible ink.
BACKGROUND OF THE INVENTION
Booklets with various type of information exist for recording data. An example of a booklet structure is described in U.S. Patent 6, 135, 503 . Described is a booklet structure in which the data sheet is placed into a laminate only in the area of the data sheet where there is information to be protected. This structure leaves the data sheet in a single layer at the seam where the booklet pages are secured together.
A booklet is described in U.S. Patent 6,089,608, in which the front and back cover have a vinyl pocket on the inside of the front and back covers. A plurality of leaves or pages are then attached inside of the cover.
An emergency medical card is described in U.S. Patent 5,197,763, which consists of a reduced in size printed document that is laminated between plastic sheets.
SUi~ARY OF THE INVENTION
The invention is a pocket size booklet for keeping statistical records of a particular person from birth. It may also be used for keeping records of an adult person. Non-tearing waterproof pages of a synthetic material, for example, Tyvek~ are used, and the data is printed, or data is written, on the pages with an indelible ink.
The pages include a water mark on each page. Pages may include medical history, physical conditions, surgeries, medications, and vaccination records of a person or child. Pages may be provided on which to place the footprints and fingerprints of a new born child.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 illustrates a cover for a Health and Immunization record;
FIG. 2 illustrates a cover for a Childhood Health and Immunization record;
FIG. 3 shows the Health record Table of Contents;

FIG. 4 shows personal information page for a child;
FIG. 5 shows a page for Statistical Information;
FIG. 6 shows a page for a Medical History;
FIG. 7 shows a page for Family Health History;
FIG. 8 shows a page of Family Health History details;
FIG. 9 shows a page for weight and height history;
FIG. 10 shows a page for Medications taken on a regular basis;
FIG. 11 shows a page for genetic testing and hospital newborn screening, including DNA and cord blood;
FIG. 12 shows a page for child developmental milestones;
FIG. 13 shows a page to contain notes;
FIG. 14 shows a page for an infant's left foot print;
FIG. 15 shows a page for an infant's right foot print;
FIG. 16 shows a page for an infant's finger prints;
FIG. 17 shows a page for tuberculosis screening;
FIG. 18 shows a page for Consent to Seek Medical Care;
FIG. 19 shows a page for Specialist and other health providers;
FIG. 20 shows a page of recommended childhood immunizations;
FIG. 21 is a page for summary of immunizations;
FIG. 22 is a page for listing immunizations;
FIG. 23 is an International Certificate of Vaccination against yellow fever;

FIG. 24 is an International Certificate of Vaccination against yellow fever;
FIG. 25 shows instructions for completing the International Certificate of Vaccination;
FIG. 26 list health considerations for traveling abroad;
FIG. 27 provides a place for photos, full face and profile, in the Health Record;
FIG. 28 shows an example for construction of the Health Record Book; and FIG. 29 shows the watermarks for each of the pages.
DESCRIPTION OF A PREFERRED EMBODIMENT
The invention is a Health and Immunization book, and it is constructed to provide a record of health, immunization, and other records for a person. In one embodiment, pages are included for records beginning with the birth of a child. If started later in life, then records are provided for an adult. The booklet is constructed on water proof, pages that will not tear, and writing or printing is done with an indelible ink so that information in the booklet becomes permanently affixed, and so water and other substances will not fade the information.

FIG. 1 shows an example of a cover that may be used for a person start at, or after birth. FIG. 2 shows an example of a cover that may be used on a booklet for a child, commencing at, or after birth. While either cover may be utilized, one as illustrated in FIG. 2 would, in a family, indicate a child record, while the cover in FIG. 1 would indicate the booklet used by an adult.
In FIG. 3, is shown an example of a Table Of Contents. This Table of Contents shows, at least in part, the information that may be recorded in the Heath Record Booklet. It provides a list of the basic health information that may be needed for a child to show what immunizations, disease, and other illness that the child may have had.
FIG. 4 list the basic information for the child in relation to residency, parents' names, and at least one name and address for emergency purposes.
FIG. 5 provides space to list medical history information, special medical conditions of the person, and any appliances used by the person.

A record of statistical information at birth, and later, is listed on the page illustrated in FIG. 6. It allows recording basic birth information, blood type, and allergies.
In diagnosing illnesses, it is at times desirable to have a family health history. This may indicate potential health factors of the child. A Family Health History may be listed on the page illustrated in FIG. 7. Space is available for family and grand parent information. To record the details of family health history, a page as illustrated in FIG. 8 may be used.
The page of FIG. 9 is for recording height, weight, and national percentile by age. This may be on at least three different ages. Notes may also be recorded.
Physician often inquire into medications taken on a regular basis. In treating a person, it is desirable to know what medications that a person is taking in order to avoid givin other medications that will conflict with previous prescribed medicines.
FIG. 10 provides a listing of medications taken on a regular basis .
To record genetic testing performed on a person, a page such as that illustrated in FIG. 11 may be used. Further developments of a child are shown in FIG. 12, and special notes may be recorded on the page illustrated in FIG. 13.
For identification purposes, an infants footprints may be placed on the pages illustrated in FIG. 14 and FIG. 15, and finger prints are recorded on the page illustrated in FIG. 16.
Information regarding tuberculosis, prescriptions given, or preventative for treatment may be recorded on the page illustrated in FIG. 17.
Normally when a parent leaves a child with a family member or other person, a consent paper is given to permit the family member or person to seek medical care for the child if necessary. This consent is listed on the page illustrated in FIG. 18. To accompany the consent, a listing of physicians for treating the child are given in FIG. 19.
Children, as they are growing up, re required to have a number of immunizations. A suggested or recommended schedule of immunizations are shown in FIG. 20. This listing will help parents to know when it is best to have their child immunized during the child's early life. To maintain a list of immunizations, the pages illustrated in FIG. 21 and FIG. 22 allow listing of dates of immunizations and the vaccines used.
When traveling abroad, it may be necessary to have specific immunizations for traveling to specific countries. A cover traveler information sheet is shown in FIG. 23, and the International Certificate of Vaccination against yellow fever, with instructions, is illustrated in FIG. 24. Instructions how to complete the International Certificate of Vaccination is shown in FIG. 25. Health Considerations for traveling abroad is outlined in FIG. 26. For purposes of identifying the person to whom the booklet belongs, photos and a listing of identifying marks or scars may be inserted in the page illustrated in FIG. 27.
FIG. 28 shows the basic structure of the Health and Immunization Record Booklet 10. The booklet may be constructed using a single saddle fold or may use several signatures. An important feature of the booklet is that the pages are made of a synthetic, non-tearing waterproof material. One example of such a material is the material Tyvek~. To provide a water-proof document, the printing in the booklet is made with a water proof or indelible ink, and the notations inserted in the booklet should also be made with an indelible or water proof ink.

Each page is 12 is secured in a cover 11 by fasteners 13.
Fasteners 13 may be staples or a stitching, preferably of a plastic, metallic, or synthetic material.
Another feature of the booklet pages is that each page has a watermark as illustrated in FIG. 29. This prevents the insertion of pages into the booklet assuring that the contents of the booklet are original and permanent.
g LAC101

Claims (15)

1. A Health and Immunization booklet, comprising:
a cover; and a plurality of water proof pages in said cover, said pages having annotated forms for entering medical history information of a person.
2. The Health and Immunization booklet according to Claim 1, wherein said pages include an authenticating watermark.
3. The Health and Immunization booklet according to Claim 1, having pages for recording the foot and fingerprints of an infant.
4. The Health and Immunization booklet according to Claim 1, wherein said booklet pages are printed with a water proof indelible ink.
5. The Health and Immunization booklet according to Claim 1, including an International Certificate of Vaccination against yellow fever.
6. The Health and Immunization booklet according to Claim 1, wherein said pages have forms for documenting the medical history of a person beginning at birth.
7. The Health and Immunization booklet according to Claim 6, including pages showing family medical history.
8. A Health and Immunization booklet, comprising:
a cover;
a plurality of water proof pages in said cover, said pages having annotated forms for entering medical history information of a person; and an authenticating watermark on each page.
9. The Health and Immunization booklet according to Claim 8, having pages for recording the foot and fingerprints of an infant.
10. The Health and Immunization booklet according to Claim 8, wherein said booklet pages are printed with a water proof indelible ink.
11 11. The Health and Immunization booklet according to Claim 8, including an International Certificate of Vaccination against yellow fever.
12. The Health and Immunization booklet according to Claim 8, wherein said pages have forms for documenting the medical history of a person beginning at birth.
13. The Health and Immunization booklet according to Claim 12, including pages showing family medical history.
14. A Health and Immunization booklet, comprising:
a cover;
a plurality of water proof pages in said cover, said pages having annotated forms for entering medical history information of a person;
an authenticating watermark on each page; and a plurality of said pages having forms thereon for documenting the medical history of a person beginning at birth.
15. A Health and Immunization booklet, according to Claim 1, including pages for recording DNA and cord blood testing, and newborn screening.
CA002361114A 2001-06-29 2001-11-06 Health and immunization record booklet Abandoned CA2361114A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/894,271 US6698797B2 (en) 2000-07-31 2001-06-29 Health and immunization record booklet
US09/894,271 2001-06-29

Publications (1)

Publication Number Publication Date
CA2361114A1 true CA2361114A1 (en) 2002-12-29

Family

ID=25402840

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002361114A Abandoned CA2361114A1 (en) 2001-06-29 2001-11-06 Health and immunization record booklet

Country Status (5)

Country Link
US (1) US6698797B2 (en)
EP (1) EP1270262A3 (en)
JP (1) JP2003054163A (en)
AU (1) AU4754402A (en)
CA (1) CA2361114A1 (en)

Families Citing this family (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030059751A1 (en) * 2000-10-30 2003-03-27 Welles Nancy Dickerson Emergency/medical documentation and communication system and method
US20030090103A1 (en) * 2001-11-09 2003-05-15 Thomas Becker Direct mailing device
US20050155876A1 (en) * 2003-12-15 2005-07-21 Tamar Shay Method and device for organizing, storing, transporting and retrieving paperwork and documents associated with the paperwork-generating introduction of a new family member
GB0400071D0 (en) * 2004-01-03 2004-02-04 Jallat Emily Child carer diary
FR2944229B1 (en) * 2009-04-10 2011-05-13 Arjowiggins Security STRAIGHT DOCUMENT COMPRISING A STRUCTURE PROVIDED WITH A WATERMARK OR PSEUDO-WATERMARK AND ASSOCIATED METHOD
US8342414B2 (en) * 2010-04-30 2013-01-01 Chapman Bryan P Multiface document
US9047713B2 (en) * 2010-04-30 2015-06-02 Bryan P. Chapman Multiface document
WO2021240724A1 (en) * 2020-05-28 2021-12-02 日本電気株式会社 Cooperation server, system, immune certificate generation method, and non-transitory computer-readable medium
JP6960184B1 (en) * 2020-08-12 2021-11-05 株式会社Patic Trust Movement history information confirmation method, its system and management server
US20220122706A1 (en) * 2020-10-16 2022-04-21 Prophase Labs, Inc. Universal vaccination online certificate issuance system

Family Cites Families (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4648189A (en) * 1985-01-18 1987-03-10 Data Medi-Card, Inc. Laminated medical data card
US4632428A (en) * 1986-12-29 1986-12-30 Brown Steven P Combination medical data, identification and health insurance card
US5197763A (en) 1992-01-10 1993-03-30 Whalen Thomas E Biomedical information card and method of making
GB2268906A (en) * 1992-07-24 1994-01-26 Portals Ltd Counterfeit protection for documents using optical effects of liquid crystal
US5330231A (en) * 1993-07-12 1994-07-19 Godfrey Phyllis M Greeting card with personal identifier and method of producing
US5397156A (en) * 1993-08-26 1995-03-14 Schach; Thomas M. Personalized book kit
GB9419226D0 (en) * 1994-09-23 1994-11-09 Wills Stephen J Identification means
US5464253A (en) * 1994-12-19 1995-11-07 Farrell; Dennis A. Squirt book
US5695066A (en) * 1997-01-02 1997-12-09 Bartlett; James R. Kit and process for use in making a personalized memento
RU2112659C1 (en) * 1997-05-23 1998-06-10 Джамбулат Мовлаевич Газдиев Medical document "personal medical book"
US6135503A (en) * 1997-11-21 2000-10-24 Giesecke & Devrient Gmbh Identification document
US6089608A (en) 1998-04-22 2000-07-18 William Exline, Inc. Booklet

Also Published As

Publication number Publication date
EP1270262A2 (en) 2003-01-02
AU4754402A (en) 2003-01-02
US20020011729A1 (en) 2002-01-31
JP2003054163A (en) 2003-02-26
EP1270262A3 (en) 2003-11-26
US6698797B2 (en) 2004-03-02

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Date Code Title Description
FZDE Discontinued