Reg. No.:

, -Yrs,
Member Id -
Case Id -
Next Visit Date -
Consulted at -
Presenting Complaints
History of presenting illness
Past Medical History

Past family History

Provisional Diagnosis
Medication Advised
S.no Medicine No of Days Dosage Intake-Frequency-Remark
1
7 1-1-1 - -
Diagnostic Tests
Advise



Reg. No.:

Disclaimer
  1. This medical advice is based on the symptoms provided by you over the telephonic consult. This is not intended to replace a physical examination by a doctor. Please visit a Doctor/Hospital for further management if your condition does not improve
  2. The information and advice provided here is provisional in nature as it is based on the limited information made available by the patient.
  3. The information is confidential in nature and for recipient's use only.
  4. The Prescription is generated on a Teleconsultation
  5. Not valid for medico-legal purpose