                                     OUT PATIENT ASSESSMENT FORM

                                                                                                                                           olive


                                          UMR260197                                                                                         HOSPITAL
             UMRNO                                                                                                                DEVOTED TO EAVWG LIVES
             Pt.Kanwe                      75Y (s)
             Age
              Gender                        De MOHAMMED ASIF S
              Consultant                    27.03.23/12:19:39 PM
               Date & Tim


                      This Consultation is valid up to 1 Week or First review visit whichever is earlier

                                        Dectar N
                                        OPresent C

 WEG-65.7 gg
                                                                                                 50on 1 7,80

388 159/68

                 meleg
                                                                                                                PLA


                                                                                                                                           ES 35
     Investigations               Treatment Plar
                                                                                                     T Rasulin Gold 10




                                                                                                                 Ammanda 200



                                                                                                           Dytà plus 10
         Echo                                                                                                                                        1-00
                                 Other : Diet Counseling / Physiotherapy / Life style aspects

                                                                                                               Cardivas 6m25


                   wildaf                                                                                                  Etrexcin 50

                               Reviews
                                                                                                                      prontacid som


   #12-2-718/3/4/5; Nanainagar X Road, Mehidipatnam, Hyderabad - 500 028
                             T. D40 40 499-500 | W: www.olivehospitals.com

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Olive Hospital', 'clinic_pharmacy_address': '#12-2-718/3/4/5; Nanainagar X Road, Mehidipatnam, Hyderabad - 500 028', 'clinic_pharmacy_city': 'Hyderabad', 'clinic_pharmacy_pincode': '500028'}, 'doctor_details': {'doctor_name': 'Dr. Mohammed Asif S', 'doctor_qualifications': 'NA', 'doctor_registration_number': 'NA'}, 'patient_details': {'patient_name': 'Pt. Kanwe', 'patient_age': '75', 'patient_gender': 'Female'}, 'prescription_details': {'date_of_doctor_consultation': '27.03.23'}, 'procedure': {'chief_complaints_diagnosis': 'Sore Throat'}, 'medicine_details': [{'medicine_name': 'Dectar N', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '7 days'}, {'medicine_name': 'T Rasulin Gold 10', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '7 days'}, {'medicine_name': 'Ammanda 200', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '7 days'}, {'medicine_name': 'Dytà plus 10', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '7 days'}, {'medicine_name': 'Cardivas 6m25', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '7 days'}, {'medicine_name': 'Etrexcin 50', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '7 days'}, {'medicine_name': 'Prontacid', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '7 days'}], 'lab_test_details': {'lab_test_names': 'Echo', 'procedure_request': 'ES 35'}}