                          Khuranas
                                                                                              HOSPITAL




                                           Punjabi Mohalla, AMBALA CANTT.

                                        C : 2633187, 9466483809, 9729598511

      M.T.P. Centre
                                                                    10:00 a.m. to 2:00 p.m.                                   Incubator U.V. Rays
      Laboratory
                                              TIMINGS : 5:00 p.m. to 7:00 p.m.                                                X-Rays & E.C.G.
      Foetal Monitor
                                                                    Sunday Evening Closed                                     Ultrasound Scan


                             Anja -


               I/We hereby consent for examination admission for

                   Biopsy / Tests/ Operation / MTP at my /

                   our own risk of the procedure/operation and anesthesia. The risk has been
                   explained to me.                    5-3-23
        CONSENT                                                                                                                                            Sign.

               Rx

                         40 Back ache                                                B.P.                 .. ..                           LMP

                                                                                    Ht.                                                   T·

                                                                                    Wt.               :

                                                                                    Hb.               :               B/Group
      o ACMR Tais                                                                                                                                                     DOPP

                                                                                    BSR           :                   TSH
                                                                                                                                                    HIV
                                                                    10
                                                                                     TL                               PRL                                           Lower
                                                                                                  :
                                                                                                                                                     HBS

                       Perzo-M                                                      HDL           :                  LDL
                                                                                                                                                    HB-C
                                                                                                                                                                    Bonar Bo
                                                                     10
                                                                                    TC                                DC
                                                                                                  :
                                                                                                                                                  VDRL
                                                                                                                      0ml

                                                                                                                     AL RIE
Adv                        USS-LowerAbd Urine .:
                                                                                                                        Sug. ME: Crytal

                                         Renal Region Stools:                                                                                  2-4 PcPe GRAPH




                                                                                   SKIN / VAG SMEAR
                                                                1



                                                                                                                                                                   IOPSY
                                                         3/3/23



                                                                                                                                                                   AGE
                                                                                                                   Dr. Satvinder Khurana
                                                                                                                         M.B.B.S ., FCGP, FCCP

                                                                                                                  Dr. Bhupinder Khurana                            OPSY
                                                                                                                         M.B.B.S ., FCGP. FCCP
          EMERGENCY OPEN 24 HOURS                                                                                                   Dr. Prit Anand
                                                                                                                                                                   SE VEI
                                                                                                          M.B.B.S ., M.Sc. (Pain) M.C.A.

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Khuranas HOSPITAL', 'clinic_pharmacy_address': 'Punjabi Mohalla, AMBALA CANTT.', 'clinic_pharmacy_city': 'Ambala', 'clinic_pharmacy_pincode': '2633187'}, 'doctor_details': {'doctor_name': 'Dr. Satvinder Khurana', 'doctor_qualifications': 'M.B.B.S., FCGP, FCCP', 'doctor_registration_number': 'NA'}, 'patient_details': {'patient_name': 'NA'}, 'prescription_details': {'date_of_doctor_consultation': 'NA'}, 'procedure': {'chief_complaints_diagnosis': 'Back ache'}, 'medicine_details': [{'medicine_name': 'PAN 40', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': 'NA'}, {'medicine_name': 'NA', 'medicine_dosage': 'NA', 'medicine_frequency': 'NA', 'course_duration': 'NA'}, {'medicine_name': 'NA', 'medicine_dosage': 'NA', 'medicine_frequency': 'NA', 'course_duration': 'NA'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}