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  • Illness and Injury Report: Sent To RLMC/ALMADINA CLINIC For Further Management

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    Victoria Gomez
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    This illness and injury report documents a skin itchiness complaint of Sujita Kumar Singh, a 26-year-old Indian national working as a general fitter. He reported to the GV Camp Clinic on August 16, 2012 with a 3-week history of skin itchiness. He was previously treated at a polyclinic and prescribed medications. He was referred to a medical clinic for further management and treatment. The nurse noted his home medications and treatment plan. The incident is classified as a non-work related illness.

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    Sujita Kumar Singh (Qcon)

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    This illness and injury report documents a skin itchiness complaint of Sujita Kumar Singh, a 26-year-old Indian national working as a general fitter. He reported to the GV Camp Clinic on August 16, 2012 with a 3-week history of skin itchiness. He was previously treated at a polyclinic and prescribed medications. He was referred to a medical clinic for further management and treatment. The nurse noted his home medications and treatment plan. The incident is classified as a non-work related illness.

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    Attribution Non-Commercial (BY-NC)
    Download as XLSX, PDF, TXT or read online from Scribd
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    Illness and Injury Report: Sent To RLMC/ALMADINA CLINIC For Further Management

    Uploaded by

    Victoria Gomez
    This illness and injury report documents a skin itchiness complaint of Sujita Kumar Singh, a 26-year-old Indian national working as a general fitter. He reported to the GV Camp Clinic on August 16, 2012 with a 3-week history of skin itchiness. He was previously treated at a polyclinic and prescribed medications. He was referred to a medical clinic for further management and treatment. The nurse noted his home medications and treatment plan. The incident is classified as a non-work related illness.

    Copyright:

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    Download as XLSX, PDF, TXT or read online from Scribd
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    ILLNESS AND INJURY REPORT

    Patient Information Name: SUJITA KUMAR SINGH Age: 26 Nationality: INDIAN Area of Assignment: CCA Section A. To be filled by the Doctor: Position: GENERAL FITTER Company: QCON BADGE NO: JBOG-82116

    JBOG Recovery Project

    Incident 00/08/2012 Time of Incident: 0000 HOURS Reported to GV Camp Clinic: 16/08/2012 at 08:40 Hrs. ROOM NO: C 5 A1 FF 3 MOBILE NUMBER: 77599230

    CHIEF COMPLAINT: SKIN ITCHINESS X 3 WEEKS Sick Leave: (Pls. tick) VS: BP: 134/85 PR: 61 T: 36.5 Hx - was previously seen at ALRAFA POLYCLINIC; was given tretinoin, calamine, and doxycyline. Yes If yes, no. of days: No

    > Sent to RLMC/ALMADINA CLINIC for further management > QRC/FLUOR NURSE informed 11:05> Cameback to GV MAC Home meds 1. Doxycycline 100 mg 1 cap BID 2.Erythromycin zinc acetate; 1 application BID > QRC/FLUOR NURSE informed

    ristan Palacpac

    Classification: (Pls. tick) Work-related Injury Work-related Illness Non-work-related Illness/Injury

    Referral: (Pls. tick) Yes If yes, referred to: __________________

    Attended by: NIKKO ANDREW B. PIGTAIN - GV MAC NURSE JBOG Recovery Project

    RLIC/Al Madinah Medical Center Al-Khor Hospital Hamad Medical Center

    Note: Please attach all relevant documentation including sick leave forms issued by RLIC, Al-Khor Hospital, etc. before forwarding to HSE for classification.

    Section B. To be filled by Health Safety and Environment (HSE) Manager

    Classification: (Pls. tick) First Aid Medical Treatment Restricted Work LTA

    If LTA, how many days?

    If Restricted Work, state details:

    Comments / Justification of Classification:

    Classified by:

    Section C. Return To Work (RTW) Certification - To be filled by JBOG Recovery Project Doctor Comments: (Please provide details) Fit to return to work Unfit to return to work Reassignment

    Important: Please fax signed copy to Qatargas Medical Center at 4473-6189.

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