In this article, we present a new way of creating annotation objects for DICOM images, using the redundant data channel. Various types of annotations, including types containing color information, are possible and annotation objects can overlap the original DICOM image on a screen. Annotation objects can be created easily using a digital pen. Scanned images used in an electronic patient record can be added to objects. Although there are various ways of manipulating annotation objects, such as insertion, addition and modification of annotation objects in the DICOM image, the original clinical image is not affected because a redundant data channel is used for the annotation. The proposed method is expected to be very useful to medium and small clinics that cannot afford picture archiving and communication systems, as the DICOM standard makes provision for the annotation of clinical images in various ways.