                                                                           FOR OFFICE USE

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                                              Brain & Spine Neuro Clinic



                 385909 12 623                                                                  Consultant Neurophysician
                82073                         Dr. Chirag Gupta
               RUPAY
              652922 ***** 3541               M.B.B.S. M.D. D.M Neurology (THBAS)                              (º 93108 65074
                                              DMC No-39933
                A0000005241810
               NAME: DOMEST C
                                                                                                                      Date: 28/2/2023
                                                    Name: Mr. Anand
     e:       VOICE #:009751
             D:RA117562

                                                    Age: Czy Ser: M Weight: 70 BP 52/74 PR 95




0                   Speciality in:

0                                                                                    PIVO C Lumbar Radiculepathy
                · Headache
0                                                                                                      (115)
80
                · Stroke

                · Seizure/Epilepsy

                · Spondylosis

                · Parkinsonism


                · Dementia

               · Demyelinating Disoder
                                                                                                 PHYSIOTHERAPY.
                                                                                                                                                                          X
                · Neuropathy

               · Muscle disorder                                             170


                                                                                                                                                  ace                  Insert    H
                                                                                 1) T. GABAPIN-NY 200mg /g 8pm.
                                                                                                                                                                       Print     S
                                                                                                                                                                       Screen



             Facilities Available:                                            (2) Y CALO-TOTAL Hab OD-                                                                  Delete


             · EEG

            · NCV                                                                    7. YOUPERITAS- A USO 150) BOX
                                                                               3)
                                                                                                                                                        er
           · EMG
                                                                                                                   1x5 days
           · RNST

          · BLINK                                                                                                   sos.

                                                                                                                                                             ft
          · REFLEX

      · VEP
                                                                                                                                        × 20014
     · TEST
                                                                                                                                                                  rl

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Brain & Spine Neuro Clinic', 'clinic_pharmacy_address': 'NA', 'clinic_pharmacy_city': 'NA', 'clinic_pharmacy_pincode': 'NA'}, 'doctor_details': {'doctor_name': 'Dr. Chirag Gupta', 'doctor_qualifications': 'M.B.B.S. M.D. D.M Neurology (THBAS)', 'doctor_registration_number': 'DMC No-39933'}, 'patient_details': {'patient_name': 'Mr. Anand'}, 'prescription_details': {'date_of_doctor_consultation': '28/2/2023'}, 'procedure': {'chief_complaints_diagnosis': 'Headache, PIVO C Lumbar Radiculepathy, Stroke, Seizure/Epilepsy, Spondylosis, Parkinsonism, Dementia, Demyelinating Disoder, Neuropathy, Muscle disorder'}, 'medicine_details': [{'medicine_name': 'T. GABAPIN-NY 200mg', 'medicine_dosage': '1-0-1', 'medicine_frequency': '8pm', 'course_duration': 'NA'}, {'medicine_name': 'CALO-TOTAL Hab', 'medicine_dosage': '1-0-0', 'medicine_frequency': 'OD', 'course_duration': 'NA'}, {'medicine_name': 'YOUPERITAS- A USO 150', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Box', 'course_duration': '5 days'}], 'lab_test_details': {'lab_test_names': 'EEG, NCV, EMG, RNST, BLINK, REFLEX, VEP, TEST', 'procedure_request': '× 20014'}}