               Shalby
               Plot B-Scheme No-5.
               Ahinsha Chowk, Kachnar City Road,                                        -Pital Jabalpur
               Vijaynagar
               Jabalpur - 482002                               UPD ASSESSMENT FORM
               MADHYA PRADESH
                                                                                                                                                                       NABH
 WASH          Tel No 07612648765                              (TO BE FILLED IN CAPITAL LETTERS)
               Fax 07612648763
                                                                                                                                                     SP
epartr
                                                         Athan Patel
               .. .. Mr./Mrs/Mast./Ms                                                                            Age : 70 days OPD No .:
PID : JA                                                             AM/PM Sex: Male 7 Female Height:
            Date:     10/3/23 Time:                                                                                                                         Weight: 3.6kg
                                            1BP                           Nationality             J History Given By : Self/Other: oth
           Address

           Diagnosis :                                                                                                                   Allergy plot kin


          History / Complaints :                                                                                            Plan of Care :

          for following




                                                             1 2mp                      D3 mast



                                                                                                                  1 m Fs dia


         General / Systemic Examination :




                                                          + Cream Alognie




                                                          - Soap Tedibeas

                                                                                                                                                                                   5


   BP




                                                         + Drop Mastica
 pp
      Investigation Advised :

                                                                                                               0.50 505




                                                                                                                                                               Dr. Vijay Pratap Singh
                                                                                                                                                    MBBS, DCH, Fellow in Neonatology
                                                                                                                                         Consultant Neonatologist & Child Specialist
      Next Follow up Date :                                                                                                                                       Mob : +91 9575801200


         SHALBY HOSPITAL
      (In Association with SMJ Trust)
      Address : Plot B, Scheme No-5, Ahinsa Chowk, Kachnar Road, Vijaynagar, Jabalpur, Madhya Pradesh - 482 002, India
      Tel .: +91 9575801200 / 9575801020 | E-mail : info.jabalpur@shalby.org | CIN : U85110GJ2004PLC44667




          REDMI NOTE 12 PRO 5G                                                                                                                 11/03/2023 12:03

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Shalby', 'clinic_pharmacy_address': 'Plot B-Scheme No-5, Ahinsha Chowk, Kachnar City Road, Vijaynagar -Pital Jabalpur', 'clinic_pharmacy_city': 'Jabalpur', 'clinic_pharmacy_pincode': '482002'}, 'doctor_details': {'doctor_name': 'Dr. Vijay Pratap Singh', 'doctor_qualifications': 'MBBS, DCH, Fellow in Neonatology', 'doctor_registration_number': 'NA'}, 'patient_details': {'patient_name': 'Athan Patel'}, 'prescription_details': {'date_of_doctor_consultation': '10/03/2023'}, 'procedure': {'chief_complaints_diagnosis': 'Allergy plot kin'}, 'medicine_details': [{'medicine_name': 'PAN 40', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': 'NA'}, {'medicine_name': 'Alognie Cream', 'medicine_dosage': 'Apply on affected area', 'medicine_frequency': 'NA', 'course_duration': 'NA'}, {'medicine_name': 'Tedibeas Soap', 'medicine_dosage': 'Use during bath', 'medicine_frequency': 'NA', 'course_duration': 'NA'}, {'medicine_name': 'Mastica Drop', 'medicine_dosage': '+ Drop', 'medicine_frequency': 'NA', 'course_duration': 'NA'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}