F-070

             tel +91 (40) 003-42666300
                           spapuz rad. bengaluru 350 105 mmbe villa, pp


                                                                                                    Nom out ! motherhood


                                                 0
                                   0
              30 days                                                                                                                Treatme AUFyo



                                                                                                      Briolact wash


                                             0                                                                                       Clinical Findings


                    30 days    X                                                                    T- Richar CR 2.


                                                                                                                                      Chief C/O
                                                                        74 month
                          Thysonoun 12.5 mg
                                                                                       (every saturday)
                                                                                                                                      Birth Defect H
         Investigations
                                                                                                                                      Family Histo W
                                                                                                                        Surgical -

         Special Assessment                                                                                                            Past History:
                                                                                                c/o Irregular periods


                                                                                                               p-134 bim
                                                         P14 -                                                 BP- 11917ETWAS

                                                                                                              nt-41.5kg

                                                                                            P         G                                 Obstetric Hi
                                         Menstrual H/O: (MP) #18123L
        13                                                                                                                               Patient Nam
                                                     Age / Gender: 25YIE CHID: 11231 1804
                                                                                                                                         Consultant
                              Date: 2/9/23

                                                                                                GYNAECOLOGY ASSESSMENT FORM

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