                                  .opaedics                 Out-Patient Assessment Form
                             uri Gopinath
                           ortho), M.Ch. (Ortho) (USAIM)
                       in Arthroscopy & Sports Medicine (Key Hole Surgery)
                                                                                                                           10
                    AD in Arthroplasty (Joint Replacement Surgery)
                   Consultant Orthopaedic, Arthroscopic & Joint Replacement Surgeon
             ad. No. 52484                                                                                                                             Apollo
                                                                                                                                  17/8/23
          ell : 94407 86007
                                                                                                                                                         HOSPITALS
             jail : gopikattamuri@yahoo.com                                                                                                           DRDO KANCHANBAGH




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



                                                         do low back hai +


              History :
                                                                                  [ IL radiulopally +




             Physical Examination :                      Adviced
                                                                              1) Xray LS Mine CAP


                                                                                                                                      lateral view in Flexion Extension

                                                                               2) Xxay Both Knees - AP (standing)

            Diagnosis :
                                                                                                                                                                                       .00
                                                                                                                                - latual
                                                                             3) TSH/FBS) Suric RAFaver sucatinine



                                                                                                                     And
           Investigations Advised :
                                                                                          CBP- ESR - Svito.

                                                4) Mal LS Alime.




           Treatment :
                                                                                               1) T. DelowEx- Of 1 luAm




                                                                                                21 T. RA20 20mg 1


          Diet Advice :
          (Nutritional Screening)                                                                                                                          7Am                  10
                                                                                           2) cap. Pregaba-m 75 (1


                                                                                                                                                                     -        10
                                                                                                                                           mg              10 pm

                                                                                                                                                                              ADinne
 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) : L85110TN 1979PLC008035
                                              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. Nuri Gopinath', 'doctor_qualifications': 'MBBS, MS (Ortho), M.Ch. (Ortho) (USAIM), AD in Arthroscopy & Sports Medicine (Key Hole Surgery), AD in Arthroplasty (Joint Replacement Surgery)', 'doctor_registration_number': 'ad. No. 52484'}, 'patient_details': {'patient_name': 'Rekla Jha', 'patient_age': 53, 'patient_gender': 'Female'}, 'prescription_details': {'date_of_doctor_consultation': '29/7/23'}, 'procedure': {'chief_complaints_diagnosis': 'Low back pain'}, 'medicine_details': [{'medicine_name': 'T. DelowEx-Of', 'medicine_dosage': '1 tablet', 'medicine_frequency': 'BBF', 'course_duration': '21 days'}, {'medicine_name': 'T. RA20', 'medicine_dosage': '20mg', 'medicine_frequency': '1-0-1', 'course_duration': 'NA'}, {'medicine_name': 'Cap. Pregaba-m 75', 'medicine_dosage': '75mg', 'medicine_frequency': '1-0-1', 'course_duration': '10 days'}], 'lab_test_details': {'lab_test_names': 'X-ray LS Mine CAP, X-ray Both Knees - AP (standing), TSH/FBS, CBP-ESR', 'procedure_request': 'NA'}}