                                      OUT PATIENT ASSESSMENT FORM


                                                                                                                                                     olive


                                            UMR200197                                                                                                 HOSPITAL
         UMANO                               ME K.V RAMA                                                                                  --------
          Pr. Nome
          ADe                                 Mak               MED ASME S
           Gender
           Consultant                         27.03.23/12:19:39 PM
            Dann & Time


                       This Coraxstation is valid up to 1 Week or Fast rwwww visit whschwer is sortie

                                           Doctor Notes
                                         (Present Complina, CBrick History/ Systemokk .... .---- /

 WEG-65.7gg


JPG 159/68




                                                                                                                             1820 18.40


      Investigations                  Treatment Pion

                                                                                                        T. Rasulas Gard 10




                                                                                                                   Azmanda 200



                                                                                                                Dytà plus 10

                                    Other : Diet Counseling/
                                                                 Un collotherapy / Life style aspects
                                                                                                           1 Cardivas 6-5


                                                                                                                                 Estoscin 50


                                  Review
                                                                                                                            pantocid om



     #12-2-718/3/4/5, Nanalnagar X Rbad, Mehidipatriam, Hyderabad - 500 028
                                 T DAD 40 499 500 [ W: www.olivehospitals.com

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