                                        Dr. TMA PAI HOSPITAL

                                         UDUPI
R
                                         IA unit of MAHE, Manipal)

DRGPRS 02                                               OP DRUG PRESCRIPTION SLIP                                                          TMA/PRESC/137401



                             Name : TRISHIKA ACHARYA                                              Date : 14-08-2023 07:38 PM

                         Hosp No : 00335319                                                Speciality : PED01_EV


                               Age : 1                                                      Unitname : PED01_EV

                           Gender : F                                                  Doctor Name : DR. DINESH M NAYAK

                         Address : 201 B KUNJIBETTU UDUPI

                                                                                                                                  Qty              Instruction
                                                                                           Dosage              Duration
    SI No.                                Name of Medicine
                                                                                                                                          1st
                TRESIVAC PFS 0.5ML ONE DOSE                                          0.5 ML SC Stat
       1
                Generic Name : MEASLES MUMPS RUBELLA VACCINE
                                                                                     4 Cap PO Stat
       2        AQUASOL-A 25000.I.U.(VIT A CAPS}
                Generic Name : VITAMIN-A-25000 LU.
                                                                                                                                     1
       3        2 CC Syringe
                Generic Name :
                                                                                                                                     2
      4         24 G Needle
                Generic Naine :
                                                                                                                                     1
                JENVAC 0.5MG PFS(japanese encephalitis vaccine)                      0.5ml
       5
                                                                                     Intramuscularly
                Generic Name : JAPANESE ENCEPHALITIS VACCINE INACTIVATED




                                                           Date :
                                                                                                                               Doctor Signature & Stamp
                                  Pharmacist Signature :
                                                                                                                                 DR. DINESH M NAYAK
                                         Pharmacist Name :                                                                            Reg.No : 33206




                                                         250mg/5w
           6. Sy calpd

                                                                     2.5 Ml RO for

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Dr. TMA PAI HOSPITAL', 'clinic_pharmacy_address': 'UDUPI, IA unit of MAHE, Manipal', 'clinic_pharmacy_city': 'UDUPI', 'clinic_pharmacy_pincode': 'NA'}, 'doctor_details': {'doctor_name': 'DR. DINESH M NAYAK', 'doctor_qualifications': 'NA', 'doctor_registration_number': '33206'}, 'patient_details': {'patient_name': 'TRISHIKA ACHARYA'}, 'prescription_details': {'date_of_doctor_consultation': '14-08-2023 07:38 PM'}, 'procedure': {'chief_complaints_diagnosis': 'NA'}, 'medicine_details': [{'medicine_name': 'TRESIVAC PFS 0.5ML', 'medicine_dosage': '0.5 ML SC Stat', 'medicine_frequency': 'NA', 'course_duration': '1st'}, {'medicine_name': 'AQUASOL-A 25000.I.U.(VIT A CAPS}', 'medicine_dosage': '4 Cap PO Stat', 'medicine_frequency': 'NA', 'course_duration': 'NA'}, {'medicine_name': '2 CC Syringe', 'medicine_dosage': 'NA', 'medicine_frequency': 'NA', 'course_duration': '1'}, {'medicine_name': '24 G Needle', 'medicine_dosage': 'NA', 'medicine_frequency': 'NA', 'course_duration': '2'}, {'medicine_name': 'JENVAC 0.5MG PFS(japanese encephalitis vaccine)', 'medicine_dosage': '0.5ml Intramuscularly', 'medicine_frequency': 'NA', 'course_duration': '1'}, {'medicine_name': 'Sy calpd 250mg/5w', 'medicine_dosage': '2.5 Ml RO for', 'medicine_frequency': 'NA', 'course_duration': 'NA'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}