Electronic Health Record

Self Reported Demographics

Date of Birth: 1973-05-10

Age: 39

Gender: M

Occupation: Business

Organ Donor: Y

Height: 185.9

Chest: 109

Waist: 96.52

Blood Group: A+

Insurance

Insurance Status: Running

Insurance ID: ICICI 45888585

Insurance Company: ICICI Prudential

Insurance Amount: 100000

Emergency Contact Person

Name: Sourabh Ghosh

Address: 67/2, Panduah Road,Panduah Hooghly

Contact No: 9333981314

Allergies

Allergies Name

Triggered By

Allergies Status

Immunization Details

Immunization Name	Due Date	Given Date
Diphtheria, Tetanus & Pertussis	1973-06-13	1973-06-13
HepA	2016-08-13	2015-04-13

Eye Test

Right Eye Vision: 6/9

Left Eye Vision: 6/8

Right Eye Power: -4.50

Left Eye Power: -2.0

Observations: Glass for constant use

Physical Exam Vitals

Blood Pressure History

BP

Date

Height History

Height	Date
172	21-08-10
178	27-03-12
180	20-06-15
182	19-05-16

Thyroid Test

T3

T4

TSH

Date

Lipid Test

LDL	VDL	HDL	Total Cholesterol	Date
124	28	39	191	28-10-13
45	16	35	96	31-01-14

Kidney Function Test

UREA	CREOTININ	DATE
18	0.8	15-11-13
17	0.7	07-03-13
28	0.72	19-08-09
23	0.72	29-11-10

Liver Function Test

SGPT	SGOT	DATE
127	45	28-10-13
70	34	15-11-13
49	24	02-02-14

Pulse Rate

Pulse Rate	Date
90	14-01-15
80	19-01-16
70	02-05-16
75	19-05-16

Temperature

Temperature °C	Date
36.7777777778	09-05-16
38.8888888889	17-05-16
36.6666666667	19-05-16

Weight History

Weight in KG	Date
90	18-11-15
82	14-04-16
87	19-05-16

Hemoglobin

Hemoglobin	Date
11.9	18-06-12
18.2	11-07-15
13.7	13-06-16

Blood Sugar

Fasting	PP	DATE
85	120	02-05-16
140	216	28-10-13
113	130	31-01-14
111	108	19-08-09

HBA1C Score

Score	Date
5.2	17-09-14
5	19-05-16
6.7	31-01-14

ESR

ESR	Date
17	19-02-10
21	01-09-14
24	24-06-14
18	13-02-16

URIC ACID

URIC ACID	Date
7	13-03-14
6.9	13-02-15
5.2	13-06-16

BILLIRUBIN

BILLIRUBIN	Date
1.1	02-04-12
0.7	13-06-15
0.5	21-05-16

Sodium Potassium

Sodium	Potassium	DATE
134	3.2	21-05-12
142	3.7	03-05-15
140	4	10-06-16

Treatment History

Lab Results

Medical Documents

Prescription

Lab Report

Prescription

Radiology Report

Lab Report

Hospitalization History

Hospital Name ID: Serampore Walshaw Hospital

Diagnosis: appendix

Hospitalization Date: 2015-07-15

Release Date: 2015-07-20

Discharge Summery: Appendicitis is a medical emergency that requires prompt surgery to remove the appendix.

Billing Amount: 8952

Hospital Name ID: Apollo Hospital Kolkata

Diagnosis: Fatty Liver

Hospitalization Date: 2016-05-14

Release Date: 2016-05-14

Discharge Summery: Ursomax 300 twice daily, Rosumac 10 Daily after diner, Low fat diet

Billing Amount: 40000

Surgery performed

Surgery Name: appendix

Hospital Name ID: Walse7888

Operated on: 2015-07-16

Surgeon Name: Dr. Apurba Adak

Surgical Report: Appendicitis is a medical emergency that requires prompt surgery to remove the appendix.

Surgery Name: Laparoscopic Gallbladder Removal

Hospital Name ID: Appl44511

Operated on: 2016-02-15

Surgeon Name: Dr. Pradip Ghosh

Surgical Report: Although there are many advantages to laparoscopic gallbladder removal, the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal is an appropriate procedure for you.

Current Medications

Medicine Name	Time of Taking	Dose	Frequency
Optive Fusion	50ml	2 drop	4 Times a day
Glucovita	300mg	1 Tab	Twice Daily

Care Provider

Care Provider Name	Contact Number	Address
Kanchan Bondhopadyay	26522607	67, A. P Ghosh Road

Current Diet

1. Low fat diabetic diet
2. 1600 calories
3. More green and leafy vegetables

Life Style Change

1. Walk for 30 minutes
2. No stress
3. Sleep for at least 8 hours

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Saltlake City, Kolkata 700091
E-mail: healthcarebangla@gmail.com

Tel: 9051282840

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Raja Banerjee

Phone- 9051282840