| DATE/TIME OF IMPLANT | MEDICAL PATIENT | ORIFN | GMRCO | V LEAD THRESHOLD IN VOLTS | V LEAD THRESHOLD IN mA'S AT .5 | V LEAD RESISTANCE (OHMS) AT 5V | R WAVE AMPLITUDE (mV) | V LEAD PSA USED | V LEAD MODEL | V LEAD MANUFACTURER | ATTENDING PHYSICIAN | FELLOW-1st | FELLOW-2nd | V LEAD SERIAL NUMBER | COMMENTS | EXPLANT DATE | V LEAD EXPLANT REASON | PROCEDURE SUMMARY | SUMMARY | ICD DIAGNOSIS | PRIMARY PROVIDER | PCC POINTER |
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