                                                                                            N.C. JINDAL INSTITUTE OF MEDICAL CARE & RESEARCH

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                 Quality Medical Care at Affordable Cost                                                  Model Town, Hisar - 125005 ((ben ZE3P, fre-125005)
          PAYCLINIC/EMERGENCY OPD SLIP                                                                      Ph : 01662-221169, 220169, 9896539128, 9895539182
                                                                                                              Email : info@ncjims.org, website : www.ncjims.org



 GSTIN : 06AAATN0713F1Z4                         N.C. JINDAL INSTITUTE OF MEDICAL CARE AND RESEARCH
 Dr. Mohit Vashisth,                             Patient Name     SHOUN                                                                                            Pay Clinic
                                                                                                                        OPD Type
M.S.                                             Address                                                                                                           01-Mar-2023 14:19
                                                                   HSR                                                   Reg. Date & Time
                                                 Age / Gender      13Y / Male        Mob :#295677883                                                                              New
                                                                                                                         Registration Charge                       200
Reg. No. : MCI-29350                             Patient ID        444438/UHID
                                                                                                                         V.From : 01-Mar-2023 V.To : 03-Mar-2023
Deptt.        : ENT                               OPD No          55853/OPC/22N                                          Daily No.                       2
         Vitals : BP             Weight 39 Height                                  Temp              Allergy :Drug                                     Food
                                                                     HR                                                                                                     Other

         Nutritional Screening : Normal/Obese/Under Nutritioned Asso. Disease : HT                                                           CAD              DM             CA         CVA
                                                                                              No                     1. 10 VAS Numeric Pain Distress Scale
         Diet : Normal/Diabetic/Salt Restricted/Renal/Diabetic Renal Pain                                                            Moderate Pain                                          1
                                                                                                LLO
                                                                                                                                                         3                                         10
         Patient History :


                                                                                             Tousthophpypte
       Presumptive Diagnosis:


         Patient Examination & Investigation Advice                              Medicine                 Strength                        Dose Instruction                              Duration




                                                                                                                                                              * Logiantes



                                                                                                                                                                                    1-01-



                                                                                                                                                                   1. 60300010


       3 7. 2 0model-p
                                                                                                                                                                                    1-01-


                                                1-01-01se




                    Online OPD Book ···· ·· ··· Google

                        Play Store À " JIMS Patient App"

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Preventive Advice : ··· ····· ······

 Follow up Advice :M.S. (ENT) (···, ···, ···)

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'N.C. JINDAL INSTITUTE OF MEDICAL CARE & RESEARCH', 'clinic_pharmacy_address': 'Model Town, Hisar - 125005', 'clinic_pharmacy_city': 'Hisar', 'clinic_pharmacy_pincode': '125005'}, 'doctor_details': {'doctor_name': 'Dr. Mohit Vashisth', 'doctor_qualifications': 'M.S. (ENT)', 'doctor_registration_number': 'MCI-29350'}, 'patient_details': {'patient_name': 'SHOUN', 'patient_age': '13', 'patient_gender': 'Male'}, 'prescription_details': {'date_of_doctor_consultation': '01-Mar-2023'}, 'procedure': {'chief_complaints_diagnosis': 'Tousthophpypte'}, 'medicine_details': [{'medicine_name': 'Logiantes', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'After Breakfast and After Dinner', 'course_duration': '3 days'}, {'medicine_name': '60300010', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'After Breakfast and After Dinner', 'course_duration': '3 days'}], 'lab_test_details': {'lab_test_names': '10 VAS Numeric Pain Distress Scale', 'procedure_request': 'Moderate Pain'}}