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