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<p style="margin-bottom: 0in;"><font face="Edwardian Script ITC, cursive">
<font style="font-size: 20pt;" size="5"><b> Dr. John G.M. Robertson</b></font><font size="4"> </font>
BSc, MD, CCFP, FRCS(C), FSOGC</font>
<br>
John G. M. Robertson M.D.
Inc.
<br>
Obstetrician
Gynaecologist
<br>
</p>
<hr>
<p style="margin-bottom: 0in;" align="right">45779
Luckakuk Way
<br>
Chilliwack, B.C.
<br>
V2R 4E8
<br><br>
(604)846-4477
<br>
Fax 846-4480</p>

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</p>

##today##
<br>
<br>##referral_name##<br>
<br>
<u><b>   Re:##patient_name##   DOB: ##dobc##</b></u>
<br><br>Dear Dr. ##referral_name##
<p> Thank you for referring this pleasant ##age## year old Gravida * Para * ##gender## who presents with  
</p>
<p><b>PAST MEDICAL HISTORY</b>:<p>

<p><b>MEDICATIONS</b>:.<p>

<p><b>ON EXAMINATION</b>:<p>

<p><b>DISCUSSION</b>:<p>

<p>Once again, thank you for this kind referral. </p>

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<td valign="top" >Yours Sincerely,</td>
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<td valign="bottom" >John G.M. Robertson, MD</td>
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