Plaintiff states as follows: This court has jurisdiction under 28 U.S.C. § 1331 and 28 U.S.C. § 13 32 Defendant advised and assisted in Crime against plaintiff Defendant knew that the crime would cause harm and suffering to plaintiff That the suffering of the plaintiff was directly caused by the illegal actions of defendant.. WHEREFORE, Plaintiff demands a jury trial and judgment against defendant in the amount of One M illion Dollars ($1,000,000.00) in compensatory damages, plus interest and costs as this Court deems appropri ate. MOTION FOR FREE PROCESS I request waiver of fees as my only income is SSA barely meeting living costs G RANTED DENIED Respectfully submitted

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MIRN: 109562

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MIRN: 109562
Vall: 1000693193

Age: G6y (11-25-1958)
centravites 50 plus oral tablet: 1 taD(s) orally once a day amoxicillin 500 mg oral capsule: 1 cap(s) orally 2 times a day
Guam Regional Modical
City
Current Location:
4-Med-Surg-East – 4232 – 1
Patient’s Home Medications on Discharge
Stop taking the following Medication
amoxicillin 500 mg oral capsule: 1 cap(s) orally 2 times a day
Continue taking the following medication:
These medications are NOT CHANGED:
centravites 50 plus oral tablet: 1 tabs) orally once a day
Start taking the following NEW medicatio
amoxicillin-clavulanate 500 mg-125 mg oral tablet: 1 tab(s) orally 2 times a (with meals)
glipizide 5 mg oral tablet: 1 tab(s) orally
acetaminophen 325 mg oral tablet: 2 tabs) orally every 6 hours as needed
Pain 1-3 or Temp over 101
amlodipine 5 mg oral tablet: 1 tab(s) orally once a day cadexomer iodine 0.9% topical gel: 1 Apply topically to affected area onc needed With each dressing change
collagenase 250 units/g topical ointment: 1 Apply topically to affected ointment topical (Every 1 week at ,09:00 on Friday, Monday, Wednesday)
Discharge Teaching Education:
DISCHARGE TEACHING/EDUCATION:

  • Discharge Instructions Given Date and Time
  • Discharge Meds Reviewed

16-Oct-2025 15:15
yes
Requested by: Lagman, Angeline (RN), 16-0ct-2025 15:13

170 Ilang Ilang St Dededo GU 96929

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