                                                                                                                                                                 Format No. : FMT/AM/03
                                                                                                                                                                         Rev. Dt. : 01/01/2016


                                                          ··. ········ ········                                                                                                 ··. ······ ·····

                                                                                                                                                                                                       ··. ··. ·.
                                                          ······· ·····, ········· (········)
                                                                                                                                                                                (······ ··· · ······· ····)
                                                          ··· ··. : ···· - ·······, ·······
                                                                                                                                                                                       ···. ···. : ·····

                                                 DARCHANA BAD JATE

········ ····· ···· :


                                                                                                                                                                                           01/04/23
···· : Cemcle                                     ·· : 27 ··· : 6 5 ..                                                                                               ······ :




                                                                                                Prescription -




                                                                                              Referring herewith Doughana




                         Adv                                                                  Badjak, 28/ Female




                                                                                                  Clo OBGY Procedure

                                   NST

                                                                                                            Investigation- NST



                                                                                                   To check a baby's heart



                                                                                                      rate before Birth.




    Name and Address of Medical Store
    Date of dispensing                                                                                                            Dispensed By :
                                                                                                                                 If entire prescription is not dispensed, specify name or
                                                                                                                                 number of medicine and quantity dispensed

                        ··· : ····· ··.·· ·· ·········· ·.·· ········ ······ ······ ·····. * ······ ··· *

                                  ··· ···· ············ ······ ··· ······ ···· 0240-2245200 / 8888889944

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'डॉ. हेडगेवार रुग्णालय', 'clinic_pharmacy_address': 'गारखेडा परिसर, संभाजीनगर (औरंगाबाद)', 'clinic_pharmacy_city': 'औरंगाबाद', 'clinic_pharmacy_pincode': 'NA'}, 'doctor_details': {'doctor_name': 'डॉ. संध्या भट्टड', 'doctor_qualifications': 'डी. जी. ओ.', 'doctor_registration_number': 'रजि. क्र. : ८५००१'}, 'patient_details': {'patient_name': 'DARCHANA BAD JATE'}, 'prescription_details': {'date_of_doctor_consultation': '01/04/23'}, 'procedure': {'chief_complaints_diagnosis': 'Referring herewith Doughana'}, 'medicine_details': [{'medicine_name': 'PAN 40', 'medicine_dosage': '001', 'medicine_frequency': 'BD', 'course_duration': 'NA'}], 'lab_test_details': {'lab_test_names': 'NST', 'procedure_request': 'Clo OBGY Procedure'}}