Free Wallet-sized Medical Information Card - PDF Form Download
Medical Information Card (Wallet Sized) serves as a portable source of your complete medical information. You can print this card in a small size and keep it in your wallet or purse for easy accessibility 24/7 even on the go.
This medical information card in wallet size has seven sections for entering your medical and other information. You may use last two sections of the wallet sized information card for adding important notes related to your health, conditions, and medicines.
This Medical Information Card is a perfect source to carry vital information about your health, conditions, medications, and other important information with you since it can be printed for your Wallet. Please print the information on the card for legibility as its size reduces upon its printing. You may also carry an electronic copy of the card on your mobile phone or other computing device for easy accessibility.
Medical Information & Emergency Contacts
Enter your full name, residential address with landmarks, and your phone numbers in first section Medical Information of Wallet Sized Medical Information Card. Proceed to section 2, Emergency Contacts and provide contact information in case of emergency. Please enter name and phone number of
- Preferred contact person in case of emergency
- Any other number you wish to provide
The next part of the medical information card of wallet size is Chronic Conditions. Please mark your response in the box provided before each applicable condition. Leave blank or strike out the conditions that are not applicable.
Over the Counter & Prescription Meds
You must type the information about each prescription medicine in the required format like medicine name, dose, and time of the dose of each medicine you require. Use separate line for giving details of each medicine if more than one. Mark your choices among the over the counter medicines listed in the next section, Over The Counter. You may choose to mark Other if your over the counter medicine is not listed and provide names of the same.
Allergy & Immunization Record
Section Allergy Record of medical information card has space for entering allergy and its reaction. Provide information about each allergy and its reaction on a separate line if more than one. Proceed to next section Immunization Record and provide the date/s of immunization for Tetanus, Flu, Pneumonia, and Hepatitis. Type the information of any other immunization in the space provided for the same.
The last two sections of Wallet Sized Medical Information Card are reserved for inputs of important notes related to your health, medication, and any other aspect you want to inform.
Preview the Medical Information Card (Wallet Sized) before you download