                       Ramakrishna Mission Sevashram                                                                                                              Phones : (91-522) 2321277, 2328486.
                                                                                                                                                                  Fax       : (91-522) 2329624
                         Vivekananda Polyclinic & Institute of Medical Sciences                                                                                   E-mail : rkmi@jvkml.org
                                                                                                                                                                  Website : www.rkml.org
                                                                   Vivekananda Puram, Lucknow 996007                                                              GSTIN : 09AAAAR1077P220
                                                                                                                                              NABH
                             39



                                                                                                   Registration Slip
                                                                                                                                                    No:PX/23/049659
         Da te                   :21-SEP-23 11:39 AM
                                                                                                                                                OP NO10P/23/068210
         Name          :Mr AMKENDRA TIWARI
          Address :NIRALA NAGAR LK UTTAR PRADESH INDIA                                           Father /Husband            :5/0 LAIE MR AWADESH TIWARI
                                                                                                                                          BeXIM Age :31/3/20
         Ctgry                  : GENERAL SUBSIDISED
         IC NO.                                                                                                                                 Grade: GENERAL
                                                                                            Dependent
         Dept            :CARDIO
                                                                                           Doc tor                    DR UJJWAL MAHESHWARI                        Room No:29
         Received a sum of Rs                                                      450.00/- Vide voucher no. RV/23/227015
         Consultation fees                                                                                                                               as

         Opera tor                    Id : ANT                                                         point Id :ANT
                                                                                                                                                21-98P-20 11:35 AM
                                                                                                  009152 200
          Complaints
                                                                                                                                                  Diagnosis




                                                                                              CoBenel 1 20 Hes




                                                                                         -TDARE 90




86/6/2
                                                                                         Bisobin 2.5
                                                                                                                                                              0




                                                                                       de Prego 10 1000




            ·········· ··········· ··· ······ ···· ···· ·· ····· ·· ······ ·····

                                        ·· ·· ···· ····· ······· ······ (Re                                                                                       ···· ·· ······· ····· ···· ····

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Ramakrishna Mission Sevashram', 'clinic_pharmacy_address': '39 Vivekananda Puram, Lucknow 996007', 'clinic_pharmacy_city': 'Lucknow', 'clinic_pharmacy_pincode': '996007'}, 'doctor_details': {'doctor_name': 'DR UJJWAL MAHESHWARI', 'doctor_qualifications': 'NA', 'doctor_registration_number': 'NA'}, 'patient_details': {'patient_name': 'Mr AMKENDRA TIWARI'}, 'prescription_details': {'date_of_doctor_consultation': '21-SEP-23 11:39 AM'}, 'procedure': {'chief_complaints_diagnosis': 'CoBenel 1 20 Hes, TDARE 90, Bisobin 2.5, de Prego 10 1000'}, 'medicine_details': [{'medicine_name': 'CoBenel 1 20 Hes', 'medicine_dosage': '1', 'medicine_frequency': 'BD', 'course_duration': '90'}, {'medicine_name': 'TDARE 90', 'medicine_dosage': '1', 'medicine_frequency': 'BD', 'course_duration': '90'}, {'medicine_name': 'Bisobin 2.5', 'medicine_dosage': '0', 'medicine_frequency': 'BD', 'course_duration': 'NA'}, {'medicine_name': 'de Prego 10 1000', 'medicine_dosage': '1', 'medicine_frequency': 'BD', 'course_duration': '90'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'विवेकानन्द पॉलीक्लीनिक में उपलब्ध जाँच बाहर से कराने पर अमान्य होगी।'}}