Reg. No.:
Address:
, ,
Member Id -
Case Id - 		Next Visit Date -
Consulted at -
Vitals Weight: Kg Height: cm BMI: Kg/m2 Blood Pressure: Temperature: ℉ Pulse: bpm Respiratory Rate: /min SpO2: % Pain: Level of Consciousness: Blood Glucose (fast/non fast): Urine Output:
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

7 1-1-1 - -
Diagnostic Tests

Prescribed Tests

  • Recommend

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. Our Doctors and Care managers for quality monitoring and provision of required services may view prescription from time to time
  4. The Prescription is generated on a Teleconsultation
  5. Not valid for medico-legal purpose