FORMAT NO. GHRC/RECP/03
                                                                                                                                                                                                                   Quality Certification
                                         ····· ········                                                                                                                                                            Bureau Inc.

                                                                                                                                                                                                       ISO 9001 : 2000 Registered Erns

                                    11/34, 73, ····· ·····, ······ ···, ····· ··· : 0141-2552668/2552667 (Enquiry No.)

                                                          (Skin, Allergy and Diabetes Super Speciality Center)
                                                                                                     (DAY CARE CENTRE)                                                             Hospital Time : 8.00 a.m. to 6.00 p.m
                                                                                                  (Wednesday Holiday)                                                                OPD Hours : 9.00 a.m. to 1.00 p.m.

········ ·· ···· ·· ··· ········ : * ····· ····· ········· (JDA) * ········ ····· ···· ····· ····· * ······ ······· ·········· ··-······· ·······

 * ········ ····· ··-······· ····· ······· (RCDF) * ····· ······· ····· ···· ······· * ···· ······· * ······· ············ ···· * ········ ····· ····

 * ········ ····· ···· * ········ ············· (Rajasthan University) * ···· (RIICO)

            ···········                                                                                                              ········-····

 ····, ·····, ····· ··· ··· ····                                                            37                                  ···· ······ 29552, ······ 10 2/2.3
                   ··. ··· ······                         ···· ······
                                                                                         MR Alakhlaque                                                                               334 PT                      Male
                                        ··. ··                                                                                                                     ····
                                                          ···· ·· ···
             ········ ······ ··· ·······
                         ······ ·······
                                                                                                                  Dilma



                 ··. ··.··. ·····
                    ········ ······· - ······
              ········ ··· ········· ·····

                                                                                                                  2 Den-woh & mnowo repas.

                       ··. ········
                   ··. ····· ······                                                                               2 Clump Luto 1030 60

                               ··.··.··. ··.
                          ······ ··· ······)                                                                       4. Fluch Belly 115h
                           ··.··. (·······)
            ·.··. ··. ··.··. (··. ··. ·.)

                                                                                                                                              Ana Leung

                              ········· ···
                     · ········· ······                                                                                 of Amigono
                    ··. ···· ·····
                       ··. ·· ., ··.··.··.




             ··. ····· ······
                  ······· ···
      ···· - 9.00 ·· 12.30 ···                             ··. ··· ······ ·· ······ · ······ ··                                         ·· ······· ··· ····· ·· ······ ···· ··· ········· ······ ···
      ······ ·· ···· ·····                                  ···· ····· ······                                                           ···· ···· ·· ····· ··· ····· ···· ···· ·· ····· ···· SMS
        ···· - 5,00 ···.6.00 ···                           ··········· ···-                                                             Hospital / ···· ···· ········ ······· ··· ······· ·····
         (By Appointment)                                  ······ 8.00 ·· 10.30 ··· ··
                                                                                                                                                                    CONSULTATION VALID FOR 5 DAYS ONLY
                                                                              Not Valid for Medico Legal Purpose
                                                                                                                           Subject to Jaipur Jurisdiction only
                                                                                                            EMERGENCY SERVICES NOT AVAILABLE

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'गिरधर हॉस्पिटल', 'clinic_pharmacy_address': '11/34, 73, गिरधर मार्ग, मालवीय नगर, जयपुर', 'clinic_pharmacy_city': 'जयपुर', 'clinic_pharmacy_pincode': 'NA'}, 'doctor_details': {'doctor_name': 'डॉ. ऋषि भार्गव', 'doctor_qualifications': 'चर्म, कुष्ठ, गुप्त रोग एवं एड्स', 'doctor_registration_number': 'क्रम संख्या 37'}, 'patient_details': {'patient_name': 'MR Alakhlaque'}, 'prescription_details': {'date_of_doctor_consultation': 'रसीद संख्या 29552, दिनांक 10 2/2.3'}, 'procedure': {'chief_complaints_diagnosis': '334 PT'}, 'medicine_details': [{'medicine_name': 'Ban 40', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': 'NA'}, {'medicine_name': 'Paracetamol', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': 'NA'}, {'medicine_name': 'Fluconazole', 'medicine_dosage': '1-0-1', 'medicine_frequency': 'Morning and Night', 'course_duration': 'NA'}], 'lab_test_details': {'lab_test_names': 'NA', 'procedure_request': 'NA'}}