             aayushya                                                                                                                                           BHRC/F&F/101/00

             DR. SHWETA BHANDARI'S                              Dr. Shweta Bhandari                                                                         OPD : 14103165
                                                                                                                                    UHID        4529841
             CENTER FOR FETAL MEDICINE                          MBBS. MS (Obstetrics & Gynecology)                                  Reg. Date: 02/09/2023
             A Unit of Bhandari Hospaal &                       FELLOWSHIP FETAL MEDICINE (UK)                                      Name        TRUPTI CHOPDA SANGHVI
             Research Center (BHRC)                             International Master in Maternal Fetal Medicine                     Age         36 Y / FEMALE
                                                                 (University of Barcelona)
                                                                 MATERNAL & FETAL MEDICINE SPECIALIST                               Mobile No. : 0990068200


                                                                 OPD Initial Assessment Form
                                                                                                                                                               18297
 SH                                                                                Obs. & Gynae
INTE                                                               (TO BE FILLED BY OPD DOCTOR AND NURSE)

                                                                                                                                               Pad No.
       Patient Name MTS. Trupti
                                                                                                   D/o W/o Harsh Sanghui
       Age
                                                                   Date 2/9/2023 OPD No. 14/03/65 UHID No. 4529841
       Address

       Height
                            163.5 cm. Weight                                                                                                   BM
                                                                                   56kg. Time in
       Vitals: Temp. Afeb "F, Pulse                                                                                                                                           / min
                                                                                   102.                /m, BP 1/4/74 mm/Hg ., RR 18
       Provisional Diagnosis: GZA, with 36, 6 wts POG with Rt.ovarian

             Pain Score endometriotic
                                                                             cyst with uterine subserosal fibroid.
                 0                                                                                                                                             9            10
                                      -             2           3                                5              6          7                   8
                No pain                                                                                                                                                   Worst pain
                            Just noticeable     Mild pain Uncomfortable Annoying pain Moderate pain Just bearable Strong pain            Severe pain Horrible pain
                                                                pain
                                                                                                                             .


       · LMP ~ 18/12/2022                                EDD ~ 24/09/2023                          · Care Plan :
                                                                                                      conservative management.
       · PMC ~ Regular. CORRECTED
                                                          EDD                                       · POG: ~ 36.6 wks


       · ML ~ 7/12 yt                                                                               · Presenting Complaint :
                                                                                                     Fmadequate
       · Obst h/o ~G2A,                                                                              clo white discharge Plv.


6


       · Past H/O~ Rt ovarian endometrionic
                                Custa 8x7 cm.

        . Family H/O
         Ls mother +father = HTN.
                                                                                                    . Treatment Orders
        · Known Allergies : ~ yet not known.
                                                                                                    R. T. CCm
                                                                                                            1-0 X1MONTH.
        · Nutritional Screening : ~ High prot. diet.                                                                                                                                   150
                                                                                                          C. FERRONOMIC PLUS
        · Physiotherapy: ~ 3rd Trimester                               exercise.
                                                                                                            0-1 X1MONTH.
                                                                                                        PICO MAXVIDA
        · Clinical Findings: ~ Pallor- Nil
                                                                                                             275F -275F × 1 MONTH.
        1) P/A Nut=34-36=FHS N +1Regular                               1448Pm
                             WKS 2) P/S
                                                                                                            Cap Clicsup v2 P) v+es × 3nights
                                              3) PIV        4ª- vaginitis ()
                                              4) Other

                                                                                                      Adv. Rescan afin
                                                                                                                                                   Doctor Sign & Name
        Vaccination Status : NT, 72 - ®                                                                              1 week
                                                                                                                                                    Reg. No.
hanc    Patient Shifted to :
                                                                                                                  Date 02/09/2023                                  Time
Opp.
         Next Follow-up Date :

                               ISO                                                        GROUP HOSPITALS

                                                                                                                                          Bhandari Hospital (BH)
                          Bhandari Hospital & Research Centre (BHRC)                                                                      MG/2, Pardeshours, INDORE-452010
                                                              ## : 0781-4711554
                           21-23 GI, Schemer No:54. Opp. Meghbout   Garden, Indore 452030                                                 Contact No. - (0731) 2551850, 2151092 Fax:0731-4733554
                           Contact No. - (0733) 4733333, 4733271. 40013

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Bhandari Hospital & Research Centre (BHRC)', 'clinic_pharmacy_address': 'MG/2, Pardeshours, INDORE-452010', 'clinic_pharmacy_city': 'Indore', 'clinic_pharmacy_pincode': '452010'}, 'doctor_details': {'doctor_name': 'Dr. Shweta Bhandari', 'doctor_qualifications': 'MBBS. MS (Obstetrics & Gynecology)', 'doctor_registration_number': 'BHRC/F&F/101/00'}, 'patient_details': {'patient_name': 'Mrs. Trupti Chopda Sanghvi'}, 'prescription_details': {'date_of_doctor_consultation': '2/9/2023'}, 'procedure': {'chief_complaints_diagnosis': 'GZA with 36, 6 wts POG with Rt.ovarian cyst with uterine subserosal fibroid'}, 'medicine_details': [{'medicine_name': 'C. FERRONOMIC PLUS', 'medicine_dosage': '150mg', 'medicine_frequency': '1-0-1', 'course_duration': '1 month'}, {'medicine_name': 'PICO MAXVIDA', 'medicine_dosage': '275mg', 'medicine_frequency': '1-0-1', 'course_duration': '1 month'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}