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260802I024 · Gomathir
Edited 11 Aug 2026, 11:11 IST
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Patient Information
Full Name
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Gender
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Marital Status
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Mobile Number
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Address
No.22, Nelhaji street, kandanur
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Register Number / UHID
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Age
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Father / Spouse Name
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Blood Group
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Aadhar Number
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Insurance Name/No
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Medical History
Condition
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Notes
Diabetes
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Thyroid Disorders
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Previous Surgeries
Allergies
Smoking History
Alcohol Use
Family History
Screening Vitals
Height
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Weight
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Blood Pressure (BP)
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SPO2
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Pulse
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Temperature
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Screening Tests
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Cbg
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Hba1C
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Ecg
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Bmd
Biothesiometry
Purpose of Visit / Department Needed
General Medicine
General Surgery
OrthoPaedics
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ENT
OBG
Pediatrics
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Others
Ophthalmology
Diabetology
Cardiology
Neurology
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Nephrology
Gastroenterology
Pulmonology
Doctor's Consultation
Chief Complaints (C/O)
Routine Checkup & Headache
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Diagnosis
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ICD codes
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Treatment Advice
Prescription Advice
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