                                                               Neurophysical
                                                                                                           RYSM WITH                                                           -i.
                                                                                                            -




                                                                                                                       Geazypay rjsuipe
                                                                                                                                                                            G-5001

                                        CH


                                         INSTITUTE OF NEUROSCIENCES SURAT
                                        Ph. No. +0261 270 6000, OPD No. +0261 270 6060                                                                                       2C BAN
                   Sr.
                            INS          Emergency No. +0261 270 6001, Stroke Line No. +0261 270 6066
                       1                Email: admin@inssurat.com, Website: www.inssurat.com                                                          GST Tin: 24AAFF|46
                       2                                                                                                                              DL NO: 20 146355, 2
                                                                                                        Date: 5/4/03
                   3                                                                                                                               20F 146357, FOOD L
                           Name of Patient :               chamaraben                                                                              MI No : C1513
                5L                                                                                                                                 etall :

                                                                                                                                                         SGST
                                                                                                                                                   Ite                               C
                                               ins- Pcm (1gm) -(1)                                                                                           Value
                                                                                                                                                                            Rate
                                                                                                                                                   10         12.75
                                                                                                                                                                        6.00
                                                                                                                                                             12.60
                                               Iv set (1                                                                                                               6.00
                                                                                                                                                             20.79
                                                                                                                                                                  6.00
                                                                                                                                                          6.73 6.00
                                                                                                                                                          1.68
                                                                                                                                                                     6.00
                                           vein Flow-22NO(1)



      You Save :
                                             vel Fix -1
   BILL IS CO
   PRESCRIPT
                                           Jelly -(1)
   RETRN MED
  Rupees One

Software by VISU



                                                                                                                                               4.55
                                                                                                                                               ER +                   54.55

                                                                                                                                               VD OFF

                                                                                                                                               T
                                                                                                                                                                       1018




NAB

Accred

                                                                                                                                          ES SURA


                                                                                                                                          1. Phone: (0261) 270
                                                                                                                                          sbsite: www.inshur




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{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'INSTITUTE OF NEUROSCIENCES SURAT', 'clinic_pharmacy_address': 'DL NO: 20 146355, 20F 146357, FOOD L', 'clinic_pharmacy_city': 'Surat', 'clinic_pharmacy_pincode': 'NA'}, 'doctor_details': {'doctor_name': 'Sr. INS', 'doctor_qualifications': 'NA', 'doctor_registration_number': 'NA'}, 'patient_details': {'patient_name': 'chamaraben'}, 'prescription_details': {'date_of_doctor_consultation': '5/4/03'}, 'procedure': {'chief_complaints_diagnosis': 'Neurophysical, RYSM WITH'}, 'medicine_details': [{'medicine_name': 'PAN 40', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'After Meals', 'course_duration': 'NA'}, {'medicine_name': 'PCM (1gm)', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'After Meals', 'course_duration': 'NA'}, {'medicine_name': 'IV Set (Flow-22NO)', 'medicine_dosage': 'As per requirement', 'medicine_frequency': 'NA', 'course_duration': 'NA'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}