                      SHREYA HOSPITAL

                                                                                              837, Shalimar Garden, Extn-1, Sahibabad, GZB.
                                                                   we care your smile           Helpline No .: 0120-4775450, 54 (50 Lines)
                        (A Unit of Shreya Multispeciality Hospital Pvt. Ltd.)
       2 your smile                                                                                       Paytm & 3 : 7838737363
                              (Govt. Registration No .: RMEE1901175)
                                                                                              E-mail:shreyahospitals37@gmail.com, Web:www.shreyahospital.com
   UD No .: 140665-                                             OPD PRESCRIPTION
                                                                                                                     27758
                                                 Department: Gyn                                                                                   Date : 1/9/2023
    R eipt No .:...
  Nine of Patient : Mrs Umke                                                                                                               : 307 Sex: P
                                                                                                                                Age: ...
   Ane of Consultant :                             Or 18h0 8m
                                                                                                                          PANEL Case
      PRESENT COMPLAINTS :-
                                                                                               10. PROVISIONAL/DIFFERENTIAL DIAGNOSIS:
                 Luil 12.1. 2020.


                  END 19.10 2048                                                               11. INVESTIGATION:



                                                        2OG - 33ml.
     PAST HISTORY :-
     OM        HTN             COPD         SEIZURE            ARTHRITIS THYROID               12. TREATMENT ADVISED: (CAPITAL LETTER ONLY):
                                            DISORDER


    3100 LMP                                                                                                 Dab Elos be IN
                                                                             .EDD.

                                                                                                                                                          0
    FAMILY HISTORY



  . DRUG ALLERGY & HISTORY :-                                                                       Jab Ancal-D 10
                                                                                                                                                                        x 15 de

  6. GENERAL EXAMINATION :-
     BP: 110/72 PULSE:                                                SPO2
                                                                                                         DA MC 10 kida 1000g
     TEMP .:                          R/R


 7. NUTRITIONAL SCREENING;
                        WEIGHT 67-91 OVER WEIGHT
    HEIGHT                                                                                               Polinia. D3 Soft-all
    Pallor/Edema/Icterus/Lymphdnode/Koilonychia/Dermatitis


 8. SYSTEMIC/ LOCAL SITE EXAMINATION :
                                                                                                                                                                                  6
                         In-2 Rn . 34 ml
                                                                                                      Ren en after 15 days




                                            ve fre of
                                                                                                                                                                 Usul




 9. PAIN:



                                           5-6                7-8    9-10
                       1-2                                                                     13. NEXT FOLLOW UP VISIT:
                                     MODERATE                   SEVERE
                       MILD
 PATIENT EDUCATION (patient is Briefed On The Following)
                          ( ) Yes.                                                     ) No
Proposed Care Plan
                                 ) Yes ...                                             ) No    SMHIGEN/FR/17
Expected Outcome              -                                                                                                                       Consultant Sign. & Stamp
                                                                                     - ) No    Rev.No.05. Dated 02/02/2023
                                ) Yes
 Possible Complication (

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