                                          MGM

                              Telf. NEW BOMBAY HOSPITAL, VASHI
 NABH ACCREDITEDta - civis. om Plot No. 35, Sector 3, Vashi, Navi Mumbai - 400703. Tel .: (022) 5066 6777 | JCI ACCREDITED



                          OBSTETRICS USG REQUISITION



                                Reshuna Pawar.
Patient Name.

                            25 yu. F.
 Age / Sex                                                             IP / OPD No.

                           De Ketki Kulkaris Ward
Consultant


 UHID


 Investigation Required

                  USG for NT/NB by


                         Dr. 8 Ketti ou 2/3/2023




Short Clinical History
                           Primi = 12.5 velu




                     20/10/2022
LMP
                                           Dr. Kethi Kulkarni.

Consultant Name.


Consultant Signature

                   20X 2002/03/17/0
Reg. No.
                                                                 DR. KETKI S. KULKARNI
                  2/3/2023.
                                                                  M.D .- OBSTETRICS & GYNECOLOGY
Date:
                                                                 F. FETAL MEDICINE

                                                                 Reg. No .- 2002/03/1710.
                                                                           MGMV/F/Rad.USG.01/Ver.1/05.08.2013

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'NEW BOMBAY HOSPITAL, VASHI', 'clinic_pharmacy_address': 'Plot No. 35, Sector 3, Vashi, Navi Mumbai', 'clinic_pharmacy_city': 'Mumbai', 'clinic_pharmacy_pincode': '400703'}, 'doctor_details': {'doctor_name': 'Dr. Ketki Kulkarni', 'doctor_qualifications': 'M.D. - OBSTETRICS & GYNECOLOGY, F. FETAL MEDICINE', 'doctor_registration_number': 'Reg. No. 2002/03/1710'}, 'patient_details': {'patient_name': 'Reshuna Pawar'}, 'prescription_details': {'date_of_doctor_consultation': '2/3/2023'}, 'procedure': {'chief_complaints_diagnosis': 'USG for NT/NB'}, 'medicine_details': [], 'lab_test_details': {'lab_test_names': 'OBSTETRICS USG', 'procedure_request': 'Dr.  Ketki Kulkarni'}}