                                                                                                    Pvt. Ltd.
                                                                                                                                                    Days/Weeks/Months/Ye
                                                                                                                                                                      fol
                                                         After appointment (9173298641
                                                                                                                                                                        en:


                                                                                                                                                                        Da
                                                                                                                                                          Others:

                                                                                                                                                         CT scan:

                                                                                                                                             -           MRI:
                                                                                                                                Lumbar stenosis
                                                                                                                                                         Xray:
                                                  effusion

                                                                         (2-3, 3-4, list facett                                         Lespine                       zesti

                                                                                                           AP                                                        PT:
                                Phalen's test : +Ve/-Ve                                                         Opp                                                   ar Sti
                                                                   FHL
                                Tendom Walk: +Ve/-Ve                                                            Abd                                                   Anor
                                                                   EHL          Toes
               +Ve/-Ve          Rhomberg:                                                                                       Fingers
                                                                                                                 Add
                                                                   I/E
               +Ve/-Ve          Lig Laxity:                                                                                                                          derne
                                                                                                                Ext
                                                                   PF
               +Ve/-Ve          Hoffman
                                                                                                                 Flex           Wrist
                                                                                 Ankle DF
                  Ab/Downy'Up    Planter                     4+                                                                                                      pane
                                                                                                                Ext
                                                                   Ext
                  AbBrisk       Ankle
                                                                                 Knee                            Flex           Elbow
                                Knee                               Flex
                   Ab Brisk
                                                                                                                 Add
                                 Supinator                         Add
                   Ab/N/Brisk                                                                                                                                        Edle s
                                                                   Abd                                          Abd
                   Ab/N/Brisk    Triceps
                                                                                                                 Ext                                                peratio
                                  Biceps                           Ext
                   Ab/N/Brisk
                                                                                                                                Shoulder Flex                        Senta
                                  Reflexes:                          Flex         Hips
                                                                                                                                                                     pmina
                                                             Rt                   Motor:                RL                      Motor:
                                  Sensations: Lt
                                              D/I
                                                                                                                                                                    aciated
                                                                                  Associated disease:
                                                                                                                                                                     of Iden
                                                                                  Bracing
                                                                                                                                                                     Biosis
                                                                                   Self image
                                                                                                                                                                    estrua
                                                                                    Treatment:

                                                                                    Others:                                                                         phol Y/

                                                                                                                                                                    : Smok
                                                                                    P/HCHT/DM/CHD/Asthma/Hyperlipidemia Thyroid
                                                                                    Bladder/Bowel Functions:                                                        erity: S

                                                                                     Clumsiness/Buttoning/holding objects: Affected/normal                          pedrip

                                                                                    Fine hand functions:                                                            rpares

                                                                                     Gait imbalance: Y/N                                                            reciate
                                               Claudication : 2 (min/km/mtr/steps                                                                                   bieg >
                                                                                                             Duration :_ D/M/Y/W
                                               Relieving factor:                                                                                                    Back p
                     Sit                                                                                     Rt arm>/< Lt arm
                                                                                                                                                                    les pai
                                               Aggravating factor: walkistand
                                                                                                             Arm pains/<Neck pain
                                                                                                                                                                     kck pa
                                               VAS Score __ /10
                                                                                                             Arm pain Rt/Lt/both
                                               Pain: same/increasing/decreasing                                                                                     Chief C
                                                                                                             Neck pain Y/N                                          ge

                                                                                                                                                  Sex: M/F Occupation:
                                                    Date: 29/11/23                                                                                                  Patient




                                                                                                                                                                     Appt 9
00 123 5433
                                                                                                                                                                    Consul
0 44162
                                                                                       76 Y 1 M /20-MAR-1947
                                                                                                                                                                    Shine F
                                                                                      Mrs AJAB KUMWAR P JAIN / FEMALE
                                                                                      10002023386799                                                                Dr. Hite
                    Hospitals

                     zydus

                                                                                                                                             DEPARTMENT OF SPINE &
                                              - BAAreten 24 v 7
       Zydus                                            Sample Collection

{'clinic_pharmacy_details': {'clinic_pharmacy_name': 'Zydus', 'clinic_pharmacy_address': 'NA', 'clinic_pharmacy_city': 'NA', 'clinic_pharmacy_pincode': 'NA'}, 'doctor_details': {'doctor_name': 'Dr. Hitesh N. Modi MS, PhD (Spine)', 'doctor_qualifications': 'NA', 'doctor_registration_number': '10002023386799'}, 'patient_details': {'patient_name': 'Mrs AJAB KUMWAR P JAIN / FEMALE'}, 'prescription_details': {'date_of_doctor_consultation': '29/11/23'}, 'procedure': {'chief_complaints_diagnosis': "Neck pain\nArm pain Rt/Lt/both\nPain: same/increasing/decreasing\nVAS Score __ /10\nArm pains/<Neck pain\nRt arm>/< Lt arm\nAggravating factor: walkistand\nBack pain >/=/<Leg pain\nbieg >/=/< Lt leg\nDuration :_ D/M/Y/W\nRelieving factor:\nSit\nTingling Numbness, Weakness\nClaudication : 2 (min/km/mtr/steps\nGait imbalance: Y/N\nrparesis/Paraplegia\nFine hand functions:\npedriparesis/Quadriplegia\nClumsiness/Buttoning/holding objects: Affected/normal\nerity: Same/Worsening/Improving\nBladder/Bowel Functions:\nSmoking Y/N_pack/no a day\nP/HCHT/DM/CHD/Asthma/Hyperlipidemia Thyroid\nphol Y/N\nOthers:\nestruation:\nTreatment:\nBiosis: Y/N\nSelf image\nof Identification\nBracing\naciated problems:\nAssociated disease:\npmination:\nMotor:\nRL\nMotor:\nRt\nLt\nSensations: D/I\nSentation N/AbN\nShoulder Flex\nHips\nFlex\nReflexes:\nExt\nExt\nBiceps\nAb/N/Brisk\nEdle sign +/-\nAbd\nAbd\nTriceps\nAb/N/Brisk\nAdd\nAdd\nSupinator\nAb/N/Brisk\nElbow\nFlex\nKnee\nFlex\nKnee\nAb Brisk\nAbBrisk\npane\nExt\nExt\nAnkle\nWrist\nAnkle DF\n4+\nFlex\nPlanter\nAb/Downy'Up\nderness:\nExt\nPF\nHoffman\n+Ve/-Ve\nI/E\nLig Laxity:\n+Ve/-Ve\nFingers\nAnoral:\nAbd\nToes\nEHL\nRhomberg:\n+Ve/-Ve\nFHL\nTendom Walk: +Ve/-Ve\nar Stigmata:\nOpp\nPT:\nPhalen's test : +Ve/-Ve\nAP\nzestigations: Blood:\nLespine\n(2-3, 3-4, list facett\nMRI:\nLumbar stenosis\neffusion\n-\nCT scan:\nOthers:\nDagnosis:\nen: Conservative/Physiotherapy/Injections/Operation/Others\nfollow-Up:"}, 'medicine_details': [], 'lab_test_details': {'lab_test_names': 'Blood', 'procedure_request': 'NA'}}