                              Orthopaedics
                                                         Out-Patient Assessment Form
                         amuri Gopinath
                    S (Ortho), M.Ch. (Ortho) (USAIM)
                  chip in Arthroscopy & Sports Medicine (Key Hole Surgery)
                 wship in Arthroplasty (Joint Replacement Surgery)                                                   10
            Alor Consultant Orthopaedic, Arthroscopic & Joint Replacement Surgeon
         regd. No. 52484                                                                                                                      Apollo
        Cell : 94407 86007                                                                                                17/8/23
       E                                                                                                                                          HOSPITALS                     ALS
             mail : gopikattamuri@yahoo.com
                                                                                                                                              DRDO KANCHANBAGH                  ZAGH




                                                                                                                                      Date : _         29/7/23.
                                                mr Rekla Jha.
            Patient Name :
                                                                                                                                      53+ Sex F
                                                                                                                          Age
               Chief Complaints :
                                                                                                      Height :                        Wt. :                   BP :



                                                      Uo low back hai +


               History :
                                                                               [ IL radiculopally +




              Physical Examination :                   Adviced
                                                                          1) Xray LS Arine CAP


                                                                                                                            -Taletal view in Flexion Extension

                                                                            2) Xxay Both Knees - AP (standing)

             Diagnosis :

                                                                                                                          - latéral
                                                                          3) TSH/FBS) Suric |RAFalesccatinine



                                                                                                                   And
            Investigations Advised :
                                                                                        CBP- ESR - Svito.

                                               4) MRI LS Apine.




            Treatment :
                                                                                             1) T. Dolow Ex-OT 1luAm

                                                                                                                                                                       0


                                                                                              2) T. RA 20 20mg 1



           Diet Advice :                                                                                                                           7Am                 (10
                                                                                              A
           (Nutritional Screening)                                                        2) Cap. Pegaba-m 75 1 .


                                                                                                                                                                      10
                                                                                                                                        my             10pm

                                                                                                                                                                     A Dinner


 Consultant's signature Date/Time :



 DMRL 'X' Roads, Kanchanbagh, Hyderabad - 500 058. Tel : 24342222, 24342211 Fax : 24342255 Casuality (Direct) : 24343333 Emergency : 1066
Regd. Office : Apollo Hospitals Enterprise Limited, No. 19. Bishop Garden, Raja Annamalaipuram, Chennai - 600 028. Tel : +91 44 28293333 Fax : +91 44 28290956
                                                          Corporate Identity Number (CIN) : L85110TN1979PLC008035

                                              For appointments or online consultation, visit www.askapollo.com

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Apollo Hospitals', 'clinic_pharmacy_address': 'DRDO KANCHANBAGH', 'clinic_pharmacy_city': 'Hyderabad', 'clinic_pharmacy_pincode': '500 058'}, 'doctor_details': {'doctor_name': 'Dr. Gopinath M.Ch. (Ortho) (USAIM)', 'doctor_qualifications': 'S (Ortho), M.Ch. (Ortho) (USAIM)', 'doctor_registration_number': '52484'}, 'patient_details': {'patient_name': 'Mr. Rekla Jha', 'age': 53, 'sex': 'Female'}, 'prescription_details': {'date_of_doctor_consultation': '29/7/23'}, 'procedure': {'chief_complaints_diagnosis': 'Low back pain'}, 'medicine_details': [{'medicine_name': 'T. Dolow', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '10 days'}, {'medicine_name': 'T. RA 20', 'medicine_dosage': '1-0-0', 'medicine_frequency': 'Morning', 'course_duration': '10 days'}, {'medicine_name': 'Cap. Pegaba-m 75', 'medicine_dosage': '1-0-0', 'medicine_frequency': 'Morning', 'course_duration': '10 days'}], 'lab_test_details': {'lab_test_names': 'Xray LS Arine CAP, Xxay Both Knees - AP, TSH/FBS, Suric|RAFalesccatinine, CBP-ESR-Svito, MRI LS Apine', 'procedure_request': 'Adviced'}}