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Published by Nikhil Kumar Singh

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Published by: Nikhil Kumar Singh on Aug 28, 2013
Copyright:Attribution Non-commercial

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08/28/2013

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PATIENT CASE PROFILE
PATIENT ID:-
©N.K.SINGH, LUCKNOW, INDIA
 
 
 
BASIC DETAILS
 
 
NAME / ना :
-
 
 
FATHER/HUSBAND NAME / िता/ित का ना:
-
 
 
AGE
/ उ:
-
 
PHOTO / फ़ोटो 
 
 
SEX /
ग:
-
[DO:
करे ]
 
MALE / ि  ुष:
-
FEMALE / हा:
-
 
 
RELIGION / धम:
-
[DO:
करे ]
 BUDDHISM /
बौध धम
 CHRISTIANITY /
ईसाइयत 
 
HINDUISM / हद  ूधम
 
ISLAM / इा 
 JAINISM /
जैन धम
 
SIKHISM / सख धम
 
OTHERS / अय 
 
PHONE/MOBILE NO. / फ़ोन/ोबाइ नबर :
-
 
 
E
-
M@IL / ई 
-
े:
-
 
 
ADDRESS /िता :
-
 
©N.K.SINGH, LUCKNOW, INDIA
 
 
 
OCCUPATION / उिजीका :
-
 
[DO:
कर]
 
 
ACCOUNTANCY(ेखा)
 
ADVOCATE/JUDGE(क/यायाधीश)
 
 
AGRICULTURE/FARMER/FISHERMAN/MILKMAN(क  ृष/कसान/छ  ुआरे/द  ूधाा)
 
 
ARMY/SAILOR(सेना/नाक)
 
 
ATHLETE(एथट)
 
 
BOOK DEALER/LIBRARIAN(ि  ुतक डीर/ाइेर कायमकाम)
 
 
BANKER(ब   कर)
 
 
CASHIER(खजाची)
 
 
CHEMIST/PHARMACIST(रसायन/फाामसट)
 
 
CONSULTANT(साकार)
 
 
DRIVER(ाइर)
 
 
DESIGNER(डजाइनर)
 
 
DOCTOR(डॉटर)
 
 
ENGINEER(इजीनयर)
 
 
GARDENER(ा)
 
 
GOVERMENT SERVICE(सरकार सेा)
 
 
HAIR DRESSER(नाई)
 
 
HOUSEWIFE(ग  ृहणी)
 
 
INSURANCE AGENT(बीा एज  ट)
 
 
JOURNALIST(िकार)
 
 
JEWELLER(जौर)
 
 
MECHANIC(ैनक)
 
 
PLUMBER(पबर)
 
 
POLITICIAN(नेता)
 
 
POLICE SERVICE/ROAD TRAFFIC CONTROLLER(ि  ुस सेा/सक यातायात नयक)
 
 
PRO/RECEPTIONIST(ोक सिकअधकार/रसेपशनट)
 
 
RADIOLOGIST/RADIOTHERAPIST/PHARMACOLOGIST(रेडयोाजट/रेडयो चकसक/औषध)
 
 
SALES PERSON(ब वयत)
 
 
STUDENT(छा)
 
 
TEACHER/LECTURER/PROFESSOR(अयािक/वयायाता/ायािक)
 
 
TAILOR(दज)
 
 
TRAVEL AGENT(याा एज  ट)
 
 
WRITER/EDITOR(ेखक/सिादक)
 
 
WELDER(ेलडर)
 
 
OTHER
(अय)
 
 
DATE / हदनाक:
-
 
 
MARITAL STATUS /
 
ैाहक थत:
-
 
[DO:
करे ]
 
SINGLE
 
एक 
 
MARRIED
 
शादश  ुदा WIDOW(ER)धा / ध  ुर 
 
DIVORCEEताकश  ुदा 
 
LIVE IN RELATIONSHIPसबध   रते   
 
©N.K.SINGH, LUCKNOW, INDIA

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