Better Diagnosis, Better Care

105-, aT ,T g, AT T:07272 -400060, 9827265457

REASSESSMENT& TREATMENT SHEET
Cerileate Ne.1
COre301
ame :..P.sA.haakaVcxbAge A.ISex ..UHID
DOD Ward/Bed

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Treatment
Assessment
ite &Time of Evaluation

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Ts

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Signature of Doctor
 Better Diagnosis, Better Care

105-g, frfaG IÉT, A G, }A T:07272 -400060, 9827265457

REASSESSMENT &TREATMENT SHEET
ne .N:.Patn:inanka..eAMA Age .ausex.M. UHID NO. M53g
HulanM....00 Ward/Bed. i ) : .
&Time of Evaluation Assessment

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Signature of Doctor
 Better Diagnosis, Better Care

105-, fta , , tar a: 07272 -400060, 9827265457

REASSESSMENT& TREATMENT SHEET
LName Age ...Sex UHID
DA DOD .Ward/Bed /.
Date &Time of Evaluation Assessment Treatmént

Signature ofboctor
 Better Diagnosis, Better Care

105-, ffac GISA, 4IG, GART HT:07272 -400060, 9827265457

ESCRIPTIONS DATE
TIME NAME TIME NAME TIME NAME TIME NAME
Dose Route Frequency

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign. Date &Time

doUSy
Doctor's Name &Sion Date &Time

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign.

Sos
Date &Time

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign. Date &Time

and Abbreviation 0=0 omitted/=work Done, N=Nil Oral, R=Retused/Vomiting H=Hold Dose, A=Absent from bed
DD=9.00AM/BD:9:00 AM9:PMITDS, 2:00PM, 10:00PM 10:00AM, 4:00PM. 10:00PM., 5:00AM
6:00AM, BD 6:00PM, TDS:6:00AM,2:00PM, QID 6:00AM, 12:00NOON, 6:00PM, 12:00Midnight
Administration of drugs half-an-hour before and after in acceptable
Use abbreviations - U, IU, QD, QOD, X,0 (Traling ZORO) ua. Co.TID O Naked Decimal Point eg: 5mg to be writen as 0.5mg
mention nuantity, Duent Rant Volume Infusions, Please Reconcile at every point transaction / any change in treatment plan
 Better Diaqnosis, Better Care

105-, freGi IÉ, GaTH : 07272 -400060,9827265457

SCRIPTIONS DATE elulay 9//24 TIME NAME

TIME NAME TIME NAME
TIME NAME
Ose Route Frequency

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign. Date &Time

Doctor's Name &Sign.

Doctor's Name &Sign.

Doctor's Name &Sign.

Doctor's Name &Sign.

Doctor's Name &Sign. Date &Time

loomToS

Doctor's Name &Sign.

Doctor's Name &Sign. 9Lme

R=Retused/Vomitting H=Hold Dose, A=Absent from bed
and Abbreviation 0=0 omitted/=Work Done, N=Nill Oral,
OD=9.00AM/BD: 9:00 AM 9:PMTDS, 2:00PM, 10:00PM 10:00AM, 4:00PM, 10:00PM, 5:00AM
6:00AM, BD 6:00PM,TDS:6:00AM, 2:00PM, QID 6:00AM, 12:00NO0N, 6:00PM., 12:00Midnight
Administration of drugs half-an-hour before and after in acceptable
be written as 0.5mc
t use abbreviations - U, IU, QD, QOD, X,0 (Traling ZORO) ug, Co, TID @Naked Decimal Point eg: 5mg to in treatment plan
emention nuantity, Duent Rant Volume Infusions, Please Reconcile : at every point transaction / any change
 Date

9827265457

UHID
No.

Date
-400060,
ETC.

RESPIRATION
DOA
T:07272
Ageg
ysex
M
PULSE,Date>

T
TEMPERATURE,
TS,

IST,

RTeTOF
o22
RECORD 84341
(2
39(3s
105-,
6260
8:
Date

104°F
105°F 103°F 100°F 98.6°
101°F
102°F F F
<95°
99°F 98°F97°F

Rate/Min.
Pulse/Heart Sign.

Min.
Respiration
/
&
Temperature: Name
Blood
Sugar
Score Total
Pain Score
Name: 39.5°
C 38.5°
C 37.5°C36.5°
C Nurse's
40°C 39°C 38°C 37°C 36°C
41°C C
<35°
SPO,
B.P.
 122G4os2S
ugs2su
g28g2826Ho34
Date 19/1
6

9827265457

No. Date
’
DOA//MhUHID
-400060,
ETC.

RESPIRATION

Date
18luR
’
O:07272
M
Q2|R
PULSE,
Sex
rH
TEMPERATURE,
79
VS,
Age
H
Date
Hto24
IIST, 9992
Gokol848
OF 22120)22
RT RECORD
105-,

104°F
105°F 103°F 101°F
102°F 100°
F 98.6°
F <95°
F
99°F F 97°F
98°

Pulse/Heart
Rate/Min. Sign.

Respiration
Min.
/
&
Temperature
: Name
Blood
Sugar
Score Total
Pain Score
Name
: 39.5°C38.5°C
37.5°C36.5°
C Nurse's
40°C 39°C 38°C 37°C 36°C
41°C <35°C
SPO,
B.P.
SJUN-2016
Better Diaguosis, Better Cune

105-, Rifa TS, YS, a T:07272 400060, HT. 98272 65457

Web: www.primehopitaldeyageBEMA l: Pprimehospitaldewas@gmail.com

Date: tf024
Patlent's Name :Mr. PS VERMA JI
Ref. Doctor AGE/SEX:79/M
:DRPAWAN KUMART
CHILLORIA MBBS, MD.
M. Mode
PARAMETERS
MEASUREMENT mm.
17. LV ID (Diastolic) 43
18. LVID (Systolic) 31
19. EF
20. IVS 53%
10
21. Posterior wall 10
22. Aorta
33
23. LA 27
24. RV 27
2-D ECHO
7. RWMA ARE PRESENT AT REST
8. IAS IIVS intact.
9. No clot / vegetation/ no Pericardial Effusion.
DOPPLER
7. MV flow E <A, AV flow VP m/sec
8. NO.MR/TRIAR
9. No significant gradient across any valves.

IMPRESSION: IHD WITH RWMA ARE PRESENT AT REST

LV MID APICAL INFERIOR AND MID
APICAL ANTEROSEPTAL WALL
ARE HYPOKINETIC
LV Gr 1DIASTOLIC DYSFUNCTiON
LVEF- 53%

DR. PAWAN KUMARCHILLORIA

MBBS,MD.

|57 LIG CIVIL LINE DEWAS MP 455001

Admin
 Prime Hospital & Research Center

105-A Civil Line Main Road Ph. 07272-253114.Mob - 9827265457

UHID No 45309 IPD No. PHRC/2024-25/0655 Month No Nov/72 IPD Form (Emergeny)
MLC No
DOA 17/11/2024 01:37PM
ediclaim No
2nt Name MR. PREM SHANKAR VERMA S/O MR. RAM PRATAP VERMA
DOB Religion Hindu Occupation
ige & Sex 79Y Male
57 LIG CIVIL LINE DEWAS MP Police Thana DOD Time
Address
455001 Bill No
Case Hospital Case
PHRC.
Nationality India
ty/Town Dewas,
nsultant DR. PAWAN KUMAR CHILLORIA (MBBS.MD ) Reg. 3899
Ward/Room No. General Ward/G14
Food Allergy
Diagnosis

RRAGR MR. PREM SHANKAR VERMA S/O MR. RAM PRATAP VERMA Prime Hospital &Research Center H,HRT

Slt AT HHA Informed Consent

Check out time is 12:00 pm

MR. PREM SHANKAR VERMA S/O MR. RAM PRATAP TET MR.PRAVEEN VERMA
VERMA
SON
7898420257
Id Signature of Admitting Clerk
57 LIG CIVIL LINE DEWAS MP 455001
Admin
16cmn 34Hz

M-Mode
/0 /2 -C
B
51 Gn 12
0,9 TIS
1.2 MI
S4-2
ECHO NEW ),0 1.9

cm2.76 (MM) RVDd D

(m1.31 ACS i
cm2,/6 (MM)dimension LA X
cm
3.35 (IM) diam root Ao + HD
01:45:28
PM Healthcare Philips
LIPS
17/11/2024

-1.2

6cm -0.6

cm
/9.5 0
mAngle0
60 Gn
MHz 1.9
PW -0.6
51 Gn H2
1.8 TIS
1.3 MI
S4-2 1.2
ECHO NEW 3,0 1.9
(PA R
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lg
mml 1.72 PO
m/s 0.656 Vel + HD
01:46:03
PM Healthcare Philips
ILIPS 1/2024 17/1

1.2
6cm
-0.6

Cm /9.7 0
mAngle0
384Gn
MHz 2.0 -0.6
CW
51 Gn H2 -1.2
1.0 TIS
1.3 MI
S4-2
CHO NEW
3.0 1.9
R (P)

lg
mml 2.68 P
 PHILIPS
17 1| 2021
01:17:0 PN
+IVSIM) L01m
XIVII(AM)
IWW (NM 0.907 m
D VS)
3.3ml
SVITekh) (M) 0.530
Heb)e)
&IVIIN( ) 317Nw ICHO
512
MI L2
US 0.9
Gn 51
232dB 17dB
C2 0
MMode

31|2 16m

17||202 4 PHILIPS
Philips lealtheare 01:16:5| PM
+ V 0.551m/s
1.22 mkj

NEW ECHO
1.2 SI2
MI I.3
TIS 0. 1
|12 Gn 51
0.6 PW
1.9 MHz
Gn 60
ImAngle0
0 /6.3 cm

0.6
16cm

1.2

Philips Ilealllhcare
HD
17/||2024
01:46:33 PM PHILIPS
+ Ve
0.567 m/s
Pd 1.29 mml lg

NE W ECHO
S2
MI |.3
TIS 1.8
0.8
H2 Gn 51
PW
0.4 1,9 MHz
Gn 60
mAngle 0
10.1 cm
0.1

16cm
0.8

17 11 2024 PHILIPS
Philips Healtheare 01:16:20 PM
 BILLING-SHEET Better Diagnosia, Beter Cune

105-, frfAi ÉT, AT Ig,aRI D)T:07272 400060,9827265457

iPESNCO-Rs

ent's Name: Rxem.shark.or.Consultant aaa.CrRSohNo..Bed No.n

culars TOTAL
egistration
om Rent-Gen. ward
Boo
om Rent -AC. Deluxe Ward
miRoom
C.U. Charges / NICU
onitor
3SoD
C.G.
pod Sugar
bulizer
Hoo
efibrillatorl Venptilator
usion Pump
Dod Transfusion
essing
thology
gital X-Ray (Film Size)
LC. Charges
ater Bed
Visit ICU
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Visit General ward Logolo00
Oxygen |o00
rsing Charge
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elLabour Room Charges
Tube/Mask
etic Gases(0xygen, Nitrogen)
Charges
Baby Care
herapy Warmer
ardiography
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-3Potuo1Moo
LAMOUNT ADVANCE PAID DISCOUNT
.Oxygen : start .Stop. Total Hrs. Rs
.Oxygen: start .Stop. .Total Hrs. Rs
..Oxygen :start Stop. ..Total Hrs. Rs
Oxygen: start
..Oxygen: start
Stop. Total Hrs. Rs
Stop. ..Total Hrs. Rs
 RIMEO 62602-23254, 99261-64397
98274-35781

ATHOLOGY
Computerizcd Patkotogy lal
M amitshree96@gmail.com

HOSPITAL
ient's Name: MR. PREM SHANKAR
Ref.No. 2425-0003099
& Sex :79 Yrs., Male Date 18/11/2024
ered by : DR. PAWAN CHILLORIA
M.B.B.S.M.D.
nsultant Dr. : DR. PAWAN CHILLORIA M.B.B.S.M.D.

SPUTUM ROUTINE

Physical Examination
Quantity 1ML
Colour
WHITE
Consistency LIQUID
Blood Absent

Microsconic Examination
Gram's Stain Smear No Bacteria is Seen.
Z.N. Stain Smear Acid fast bacilli are not detected

DR. N.RAJ
M.B.B.S.DCP
(PATHOLOGIST )

PRIME
PATHOL06Y
Hgations have technical and biological limitations. Please correlate clinically as well as with other investiaative findings.
aisparity. This Report is not valid for medicolegal purpose.

105-A, Civil Line Main Road, Dewas - M.P. 455001

 DEWAS DIAGNOSTICS
CT SCAN & MRICENTRE
" 1.5 Tesla MRI Multi Slice CT Scan 3D, 4D Sonography
Digital X- ray Digital Mammography
" Echo- Cardiography Digital OPG Pathology TMT
106, Civil Lines, Dewas, Phone: 07272-404287, 254637

ent: Mr. P.S.Verma Age/Sex 79Y/M

sultant: Dr. P.K.Chilloriya MD Date 17I11/2024

16 SLICE SPIRAL HRCT SCAN OF THE CHEST

ervations:
changes of centriacinar emphysema noted in both lung parenchyma.
re are changes of interstitial septal thickening noted in enter as well as intra
ilar regions of both lung parenchyma. Interspersed areas of low density
und-glass attenuation is also noted bilaterally.

segmental areas of consolidation seen in the superior segment of the left

er lobe.

dchanges of traction bronchiectasis bronchiolectasis is noted bilaterally.

chea &main bronchiare normal in symmetry &calibre.
re is no evidence of any obvious mediastinal adenopathy.
-re is no pleural effusion.
enerative changes are noted in bold

all hiatus hernia noted.

 DEWAS DIAGNOSTICS
CT SCAN & MRICENTRE
" 1.5 Tesla MRI Multi Slice CT Scane 3D, 4D Sonography e Digital X- ray e Digital Mammography
" Echo- Cardiography Digital OPGe Pathology TMT
106, Civil Lines, Dewas, Phone: 07272-404287, 254637

clusion:
Mild changes of centriacinar emphysema noted in both lung parenchyma.
There are changes of interstitial septal thickening noted in enter as well as
intra lobular regions of both lung parenchyma. Interspersed areas of low
density ground-glass attenuation is also noted bilaterally.
Subsegmental areas of consolidation seen in the superior segment of the
left lower lobe.
Mild changes of traction bronchiectasis bronchiolectasis is noted
bilaterally.
ve changes are likely suggestive of acute on chronic infection. Clinical
relation and followup is suggested

ikrant P

SULTANT RADIOLOGIST
 PRIMEC 62602-23254, 99281-64397
98274-35781

PATHOL0GY amitshree96@gmal.com
Pathology Lab
Jully Computerized HOSPITAL
VERMA Ref.No. : 2426-0003077
Patient's Name: MR. P,S, Date :17/11/2024
Age & Sex : 79 Yrs., Male
: DR. PAWAN CHILLORIA M.B.B.S.M.D.
Refered by
Consultant Dr. : DR. PAWVAN CHILLORIA M.B.B.S.MD.
Hacmatology Examination
Test Name Result Normal Range
Heamoglobin 14.1 gm/dl M: 13,5-18.0 F: 11-16
Total WBC Count 13,500 /cumm 4,000- 11,000

79 % 40- 75
Neutrophils
Lymphocytes 16 % 20- 50

Monocytes 03 % 0-10

Eosinophils 02 % 1-6

Basophils 00 % 0-1

P.C.V. 40.3 % M: 40-52F:35-45

R.B.C. Count 4.51 mili/cumm M: 4.5-6.5 F: 3.5-5.5

M.C.V. 89.36 fl. 74 -96

M.C.H. 31.26 pg. 27-32

M.C.H.C 34.99 gldl 30- 35

E
Platelet Count 4.58 lacs/cumm 1.5-4.5

PATHOL08V: DR. N.RAJ

M.B.B.S.DCP
(PATHOLOGIST )

Cal limittions. Please correlate clinically as well as with other investiqative findings.
eny disparity. This Report is not valid for medicolegal purpose.

105-A, Civil Line Main Road, Dewas - M.P.455001

 PRIMEO 62602-23254., 99261-64397
98274-35781

PATHOL0GY
Patkology Lat
M amitshree96@gmail.com

Fully Compaterized
HOSPITAL
Patient's Name: MR. P,S, VERMA Ref.No. : 2425-0003077
Age &Sex : 79 Yrs. Male Date :17/11/2024

Refered by : DR. PAWAN CHILLORIAM.B.B.S.M.D.

Consultant Dr. : DR. PAWNAN CHILLORIA M.B.B.SM.D

Test Name Result Normal Range

Biochemical Examination
GLUCOSE RANDOM 123.0 mg/dl upto 140

SGP.T. 38.0 IU/L upto 40

BLOOD UREA 22.0 mg/dl 15 - 40
S. CREATININE 1.1 mg/dl 0.5- 1.5

Serology
SALMONELLA TYPHIO 1:160
SALMONELLA PARA-TYPHI'H' 1:160
SALMONELLAPARA-TYPHIAH" Negative
SALMONELLA PARA-TYPHI BH Negative

DR. N.RAJ
M.B.B.S.DCP
(PATHOLOGIST )

PATHOL0EY
l limitations, Please correlate clinically as wel as with other investiqative findings.
y disparity. This Report is not valid for medicolegal purpose.

105-A, Civil Line Main Road, Dewas - M.P. 455001

 0GENER

PRIME HOSPITAL & RESEARCH CENTRE, DEWAS (MPI

 Setter Diaguosil. Setter

taldewas.com, E-mail : pi

shless Facility 012720

ARE) HEALTH INSU

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INSURANCE
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HEALTH PLANNIN
FHPL)
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EALTH INSURANCE
HEALTH INSURANC
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AC:ON
NRAL INSURANCE
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KSHA TPA 1omm/mV

H TPAHEALTH INS
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