                                       OUT PATIENT ASSESSMENT FORM


                                                                                                                                                      olive


                                            UMR260197                                                                                                   HOSPITAL
             UMRNG                          Mr.K.V RAMAKRISHANAN                                                                             DEVOTED TO SAVING LIVES
             Pt.Name                         75Y(5)
                                              Male
             Gender                          Dt.MOHAMMED ASIF S
             Consultant                      27.03.23/12:19:39 PM
              Date & Time


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

                                         Doctor Notes
                                         (Present Comp        saint C        of Histn          ystemetic           aminathe
 WEG-65.793


385 159/08                                                                                                     COD Alum

                 mmelig                                                                                               PRA


                                                                                                                                                        E5 35

     Investigations
                                                                                                            T. Rosulin Gold 10




                                                                                                                       Ammarda 200



                                                                                                                    - Dyto plus 10
         Eche                                                                                                                                                     1-010
                                   Other : Diet Counseling / Physiotherapy / Life style aspects
                                                                                                                        Cardivas 6-5
                                                                                                                                                                             9   -1

                                                                                                                                     Extrcocin 50
22
                                  Review
                                                                                                               1              prontoad Dal
                                                                                                                                                                       100
     ¥12-2-718/3/4/5, Nanalnagar X Road, Mehidipatnam, Hyderabad - 500 028
                                 T: 040.40 499 500 |W: www.olivehospitals.com

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Olive Hospital', 'clinic_pharmacy_address': '12-2-718/3/4/5, Nanalnagar X Road, Mehidipatnam, Hyderabad - 500 028', 'clinic_pharmacy_city': 'Hyderabad', 'clinic_pharmacy_pincode': '500 028'}, 'doctor_details': {'doctor_name': 'Dr. Mohammed Asif S', 'doctor_qualifications': 'NA', 'doctor_registration_number': 'NA'}, 'patient_details': {'patient_name': 'Mr. K.V Ramakrishanan', 'age': 75, 'gender': 'Male'}, 'prescription_details': {'date_of_doctor_consultation': '27-03-2023'}, 'procedure': {'chief_complaints_diagnosis': 'Systemic aminatha and sore throat'}, 'medicine_details': [{'medicine_name': 'PAN 40', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': '1 Week'}, {'medicine_name': 'COD Liver Oil', 'medicine_dosage': '1-0-0', 'medicine_frequency': 'Morning', 'course_duration': '1 Week'}, {'medicine_name': 'Amodart 0.5', 'medicine_dosage': '0-0-1', 'medicine_frequency': 'Night', 'course_duration': '1 Week'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}