                        (Giriraj                                   Patient Name                                            EMERGENCY DEPARTMENT ASSESSMENT /
                                                                   IP No. / UHID No. 1                                                                        DISCHARGE SUMMARY
                                     Hospital
                                                                  Consultant
                                                                  DOA :                                                                                  1:22 Pm
                                                                                                                             Time of Arrival :
                     (1) Date : 1318123
                                                                            ghughy                                          Age / Sex :          20 F
                     Patient's Name : Kinfal

                    Allergies          No
                                                                                                                                                              Yes            No
                                                                            Wheelchair                             Stretcher                     MLC
                    Mode of Arrival : Walking

                    Referred by                 Hospital N't
                                                                                          DA on Call Dr.                                                 DA
                  Primary Dr.
                 (II) Status of Arriaval : (1) Concious / Semi - Concious / Drowsy / unconcious (2) Lines ( If any )

                                                    Red                         Yellow                          Green                            Black
                 (III) Triage
                 (IV) Physical Examination
                                                                                            VITAL SIGNS.
                                                   Temperature                       BP                          Pulse                             RR                           SP O2
                       Time
                                                                                                                 96/min                                                       95 Y. RA
                 7:22 PM                         97.5F                      110180                                                               20 min

                                                                            mutig
                                                X HTN                  KIHD                                DM                     X] Pregnancy
              (V) Past History :
                                                17 Major Surgeries
                                                                                                                                                                              lip
                                                           Py that ? c/o swelling                                                                             avver
             (VI) Chief Complain :
                      since                     2:00 pm
                                         c/o Itching over lip
                                                                                                            Pt fecking Hormonal Therapy


                                        Systemic Examination                                                                                           IX

         CVS SIS20

         PIA soft

         CNS cto
            CS 15/15

         UPILS OBERL

                                                                      SIB cmo                                                           on dis
       RX

         IlV Avil (A)
                                                                     stat                                               T. Avil                                    1.0-1
            Il Hydrocort (IA)
                                                                                                                                                                                                  Rd
                                                                                                                          T. Allegra(120) 1-0-1
             Ilv dazole (A) -1

                                                                                                                            T.Chilkul DSR-1-6-1



                                                                                                                                      T/M Follomp wit


                                                                                                                                                                           DS Devamy
                                                                                                                         soft diet.
                                                                                                                                                                                         Ambali



 (IX) Provisional Diagnosis

 (X) Advises for Discharge / Dama :                                                                                       Admission under Dr.

(XI) Time of Completion of Assessment :
                                                                 Drs das shit
(XII) Attendant CMO Name & Sign .:

(XII) on duty Medical Officer Name & Sign .: DS pradip

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Unknown', 'clinic_pharmacy_address': 'Unknown', 'clinic_pharmacy_city': 'Unknown', 'clinic_pharmacy_pincode': 'Unknown'}, 'doctor_details': {'doctor_name': 'Unknown', 'doctor_qualifications': 'Unknown', 'doctor_registration_number': 'Unknown'}, 'patient_details': {'patient_name': 'Kinfal Ghughy'}, 'prescription_details': {'date_of_doctor_consultation': '13/18/123'}, 'procedure': {'chief_complaints_diagnosis': 'Swelling and itching over lip'}, 'medicine_details': [{'medicine_name': 'PAN 40', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'After meals', 'course_duration': '6 days'}, {'medicine_name': 'Allegra(120)', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'After meals', 'course_duration': '6 days'}, {'medicine_name': 'Chilkul DSR', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'After meals', 'course_duration': '6 days'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}