       YASHODA
                                                                                                                                              card
        Super Speciality Hospitals
                                                                           OPD CONSULTATION
                         Preeti Sharma Age [Sex 36y/F                                                                                        601563
Patient Name                                                                                                            ,. Regn. No.

Doctor's Name .....                                                                                     Date 3/10/23                                  Time


  1. Nutritional Screening                    CONTU                                              6. Investigations Advised :
  Height                     Weight                      BMI ..
  2. History : (Present/ Past/ family) 9868881155




                                                                                                  7. Provisional/ Differential Diagnosis :

     Any Drug Allergy :                                                                                                italy rashes on base

    3. General Examination :                                                                                                           armal forcom.

        BP:                          Temp :               Pulse :               R/R :
        Pallor / Oedema / Koilonychia
                                                                                        HDP.DM
     4. Systemic Examination :                                                                    8. Treatment Advised :
                                                                                                         Tab. Defra (6) up
              CVS
                      T. CornimetE
                                                                                                                                                ABF)                10
              CNS :                                                            (10)

                                                                                                                                     Montair-fx
              RS:                                                                                Tab.


               PIA:                                                                                                                                                     15


                                                                                                  Tab. Doxyhac LB
              Others :

                                                        5
                                                                                                                                                                   15
                                                                                                        Deviva-CMS 0.1% gaf
        5. Pain
                                                  -
              Score :                                                                               Follow up Due On 27
                                  No Pain       Med Pain Moderata Pain Severe Pun

        Patient Education (Patient is briefed on the following )                                                                              DR. GARIMA GUPTA

                                                                   Expected Outcome : Yes / No                       Possible Complicatie               Yes I No
        Proposed Care Plan : Yes / No

                                                                                                   Name and Sign. of Patient / Attendant
       Name and Sign. of Doctor ....

                          H-1, 24, 26, 27, Kaushambi, Near Dabur Chowk, Ghaziabad-201010. Ph .: 0120-4181900. 4189500, 8506069461
                                    For Enquiry : admin.yhk@yashodahospital.org . For Feedback . feedback@yashodahospital.org
                                                                        Website : www.yashodahospital.org
                                                                                                                           155HU/OPOPORD CONSLESATION FORMVERY AUJUNE 2001

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'YASHODA', 'clinic_pharmacy_address': 'H-1, 24, 26, 27, Kaushambi, Near Dabur Chowk, Ghaziabad-201010', 'clinic_pharmacy_city': 'Ghaziabad', 'clinic_pharmacy_pincode': '201010'}, 'doctor_details': {'doctor_name': 'DR. GARIMA GUPTA', 'doctor_qualifications': 'NA', 'doctor_registration_number': 'NA'}, 'patient_details': {'patient_name': 'Preeti Sharma'}, 'prescription_details': {'date_of_doctor_consultation': '3/10/23'}, 'procedure': {'chief_complaints_diagnosis': 'Pain'}, 'medicine_details': [{'medicine_name': 'Tab. CornimetE', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '6 days'}, {'medicine_name': 'Tab. Defra', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '10 days'}, {'medicine_name': 'Tab. Montair-fx', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '15 days'}, {'medicine_name': 'Tab. Doxyhac LB', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '15 days'}, {'medicine_name': 'Deviva-CMS 0.1% gaf', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '15 days'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}