S.L. RAHEJA
                                HOSPITAL

A 1t Fortis ASSOCIATE

                                                   OPD CONSULTATION FORM                                                                            5/5/23
                                                                                                                                    Date:

New Consultation / Follow up
                                                                                                                                    UHID 1018586
                                                            menta
Name: ms. marti

                                                                                                      Allergy (Food / Drug):
                             ., Height (cms): ..            .. Weight (kg):
Age / Sex :.

                                                                                                                               Signs of Malnutrition: Yes / No
   utritional Status: Moderate / Average / Poor:



     es, specify:
                                                                                                                                 Dr. SIDDHARTH M. SHAH
                                                                        Dr. SIDD ........ . .. SHAH
                                                                                                                                 Orthopedics and Joint
   istory / Clinical Examination:                                        Orthopedics and Joint
                                                                                                                                 Replacement Surgeon
                                                                        Replacement Surgeon                                      Reg. No .: 2007062148
                                                                         Reg. No .: 2007062148
                                                                              5/5/13




                                                         6 weeks best of

   an of Care:

                                                           asymptomatic.




                                                           Knee- full extension


                                                                                       6- 130
    eventive Aspects:

                                                        Ambulal                                        Adv




   pal of Treatment:                                              7. CALPOL (650) ses if fain



                                                           (Upto 3/day ; at 8 hours unkovas)




                                                        continue medical & as usual




Follow up advice:                                          Flup. after 1 year/55
                                                                                                                                                    88cl




LRH/NS/31/RO-2022.02

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'S.L. RAHEJA', 'clinic_pharmacy_address': 'HOSPITAL', 'clinic_pharmacy_city': 'NA', 'clinic_pharmacy_pincode': 'NA'}, 'doctor_details': {'doctor_name': 'Dr. SIDDHARTH M. SHAH', 'doctor_qualifications': 'Orthopedics and Joint Replacement Surgeon', 'doctor_registration_number': 'Reg. No .: 2007062148'}, 'patient_details': {'patient_name': 'Ms. Marti'}, 'prescription_details': {'date_of_doctor_consultation': '5/5/23'}, 'procedure': {'chief_complaints_diagnosis': 'Knee- full extension, asymptomatic'}, 'medicine_details': [{'medicine_name': 'CALPOL (650)', 'medicine_dosage': 'Upto 3/day', 'medicine_frequency': '8 hours', 'course_duration': '6 weeks'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}