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LIFECARE NCS/EP/EMG REPORT

Hospital Musaffah
A unit of VPS Healthcare
Neurolgy Department

Patient Information Generated: 30 Aug 20

D
LC80140243 Date of birth 01 Jan 75
Name MUHAMMAD IRSHAD MUHAMMAD In Out
Sex
Out
Male Doctor Dr. SAJID SYED
Age 45
Examiner
Weight Refering Department NEUROLOGY
Height Examination Date 30- Aug 20

History

Comment

Motor Nerve Conduction Study

Site Lat Dur. Amp. Area Segment Distance Interval NCCV CCV N.D Temp.
Median Left
Palm 1.7ms 5.4ms 7.2mV 16.7mVms *Palm 1.7ms
Wrist 5.9ms 6.6ms 6.8mV 23.4mVms Palm-Wrist 4.3ms
Elbow .1ms 6.1ms 4.7mV 17.3mVms Wrist-Elbow 220mm 5.2ms 42.3m/s

Median Right
Palm .3ms 5.1ms 12.0mV 30.1mVms *Palm 1.3ms
Wrist 3.7ms 6.0ms 8.0mV 23.9mVms Palm-Wrist 2.5ms
Elbow 8ms 6.2ms 7.6mV 24.2mVms Wrist-Elbow 220mm 4.1ms 53.7m/s
Ulnar Left
Wrist 2.2ms 4.Tms 10.0mV 24.3mVms Wrist 2.2ms
Elbow 6.11ms 5.4ms 9.4mV 23.8mVms Wrist-Elbow 240mm 3.9ms 61.5m/s
Ulnar Right
Wrist 1.9ms 5.Oms 10.8mV 28.7mVms *Wrist 1.9ms
Elbow 7ms 5.5ms 9.5mV 27.3mVms Wrist-Elbow 240mm 4.8ms 50.5m/s

Sensory Nerve Conduction Study

Site Lat.1 Lat2 Amp. |Area |Segment Distance |Interval NCV CCV N.D. Temp.
Median Left
Wrist 4.1 5.8ms 5.6uV 0.7uVms Wrist 140mm 4.1ms 34.Om/s

Median Right
Wrist 3.0ms 3.7ms 22.9uV 1.3uVms Wrist 140mm 3.Oms 47.Om/s

Ulnar Left
Wrist 1.9ms 2.6ms 28.8uV 2.3uVms Wrist 140mm I.9ms 75.3m/s
Ulnar Right
Wist .7ms 2.5ms 30.8uV 3.5uVms Wrist 140mm .7ms 80.5m/s
F-wave
Nerve Side Stim.Site F-Lat F-LatN.D. |M Lat. F-M Lat. F-Occur. Distance FWCV N.D.
Median Left Wrist 34.5ms 6.3ms 28.2ms 2/11,18
Median Right Wrist 27.9ms 3.8ms 24.1ms 710,70 %
Ulnar Left Wrist 27.3ms 28ms 24.6ms 8/8.10%
Ulnar Right Wrist 26.7ms 2.5ms 24.2ms 9/9 .10 %
Remarks
MNCV: Left median distal latency is prolonged. Normal distal latencies, CMAP amplitudes and
motor nerve conduction velocities on right median and both ulnar nerves.

SNCV: Both median peak latencies are prolonged with reduced SNAP amplitude from left median
nerve. Both ulnar nerves showed normal
findings.
FWave: Latencies are within normal limits in all studied nerves.

Conclusion: Nerve conduction study suggestive of left moderate

mild carpal tunnel syndrome.
carpal tunnel syndomèand right

Disclaimer
The above mentioned diagnosis is based s be
upon test findings. This is not a final diagngr
correlated with clinical diagnosis and other investigations.
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Bill To Invoice No: s)lii SF14643
CASH CUSTOMER Date 18-Aug2020
Terms:
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Currency AED

TRN Number: s 100202536700003

Sr # Item Code Description Quantity Rate(incl. Tax Tax Amount

1 A715F SAMSUNG MOBILE A71 TRA 1 00 1,228.00 48 1,228.00

PCS 5%
2 HF7582 SAMSUNG HEAD PHONE 758 1.00 10.00 0.48 10.000
PCS 5%

Bill Amount 1,23800 Cash Tendered 1,238.00 Change Cash: 0.00

Receipt Details
Bill Amount Paid Balance Due
1 238 00 1,238 00

2 58.95 1,238.00
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Tax Detailsla JJsli
Total Before VAT a inl Ji s 1,179.05
F] VAT(5%) 58 95
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Grand Total Inclusive Of Tax: One Thousand Two Hundred Thirty-Eight Only
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"Thank You For Your Business" Rece ver Signature

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TAX INVOICE Date
TRN: 100557075700003
: 20-Sep-20
Sales Man a a l ibp : COUNTER

SLNo Code Description J Qty Unit Price VAT 5% Amount

1 SAM-MOB M11 3+32 SAM-MOB M11 3+32 1 440.00 20.95 440.00

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WARRANTY

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Amount in Words. 1.00 Gross Amount Before VAT 5% Lai iil i JY 419.05
Total Qty: Discount
FOUR HUNDRED FORTY DIRHAMS 0.00
Total VAT Amount 5% 20.95
Net Amount With 5% 440.00

Reciever Signature i For LANDMARK MOBILE PHONES & ELECTRONICS

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Near Wazeeristan Hotel, Abu

Dhabi -U.A.E. E-mail 9186, Mussafah M-11

TRN #: 100333308300003
arafatyres@gmail.com
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TAX INVOICE

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Receiver's Signature
Signaturee
 Tips for Peace of Mind

#Reduce the amount of time you read the newspapers or watch the news on TV.

# Stay away from negative conversations and from negative people.

Don't hold complaints. Learn to forget and forgive. Nurturing ill feelings and
grievances hurts you and causes lack of sleep.

# Dont be jealous of others. Being jealous means that you have low self-esteem and
consider yourself inferior to others. This again, causes lack of inner peace.

#Accept what cannot be changed. This saves a lot of time, energy and worries.

#Everyday we face numerous inconveniences, irritations and situations that are

beyond our control. If we can change them, that's fine, but this is not always possible.
We must learn to put up with such things and accept them cheerfully.

#Learn to be more patient and tolerant with people and events.

#Don't take everything too personally. Some emotional and mental detachment is
desirable. Try to view your life and other people with a little detachment and less
involvement. Detachment is not indifference, lack of interest or coldness. It is the
ability to think and judge impartially and logically. Don't worry if again and again you
fail to manifest detachment. Just keep trying.

#Let bygones be gone. Forget the past and concentrate on the present moment.
There is no need to evoke unpleasant memories and immerse yourself in them.

# Practice some concentration exercises. This will help you to

reject unpleasant
thoughts and worries that steal away your peace of mind.

#Learn to practice meditation/prayer. Itwill, no doubt, change your life.

Inner peace ultimately leads to external peace. By creating peace in our inner
world, we bring it into the external world, affecting other people too.

A
 nCRC ( zGs
Alhayat
Clinic&Research Center

PMDC # 4214-N

Patient ID. 36507-2 14 Date: Wed 09-08-2017

Name Hussain Irshad S/o M Kamal Gender Male Age 42 Address Hangu
Anx/Dep, Dyspepsia, Altered Bowel Habits, Gas
Syndrome
Feeling Febrile, Aches and Pains, Weakness, Lack Pulse 80 /min
of Energy
BP: 120/80 mm.Hg

Temp 98.4 0F
Rx
First Visit : Thu 05-11-2015

COLOFAC 135 mg. Tab o 1

2 GANATON-OD 150 mg, Tab o 1

3 PROTIUM -40 mg, Tab ol 1

4 ZAVGET 10 mg, Tab ole 4

5 SURBEX-T Tab l 1

Professor

Dr. Javed lqbal Farooqi

FCPS (Gastroenterology
FCPS (Medicine),
LRH Peshawar
Medical D Ward,
In-charge

* * * * **************************************************************************************************************************************************************************************************************************a **************.************.

Not Valid for court 0334-9038182-ahe ikivoh2L

 Patjent Name. Muhammad Irshad Muhammad Kama
Quality Car sicediona
LIFECARE 3 Hussain Gender: Male Weight 119.0 KG
Age: 45 years
Hospilo Muzofrh Address: Umm Al Nar Tel.: 971506644719
Case number 8000748239
1.ah,a Patient number: 80140243
Department NEUROLOGY
Entitement. ENET TPA
Insurance card number ARH-0214-E
Emirates ID: 784-1975-3862860-9

PRESCRIPTION FORM FOR NON-CONTROLLED MEDICATIiONS ONLY

30.08.2020 15:49 Prescription ID 10020936930

Prescription date

Principal diagnosis M79.2

Secondary diagnosis : G56.01, G56.02

Allergles No Known Allergy

Generic name/Strength/Form Dose/Cycle/Route Duration Qty. Refill Qty.

Disp.
FLAMINGO CARPAL TUNNEL SPLINT 1 Box/Daily/TOPICAL 30 days 30 BOX

/BOX
VITAMIN-B12 (MECOBALAMINE)/ 1 Tablets/ BID (twice daily) / 3 0 days 2 BOX
TABLETS ORAL

Pharmacy signature

Dr.4d Syed
UC No:GO19349
Doctor Name DeSajideSyed.u

License Number GD19349

thtNeurology
O rS
. aijd
Syed

Page
Printed
30.08.2020-1549
 Patient Name: Muhammad Irshad Muhammad Kamal,
Glty atsbrcatr
LIFECARE Hussain
Age 45 years Gender Male Weight 119.0 KG
Address Umm Al Nar Tel.. 971506644719
Patient number 80140243 Case number: 8000748239
Department NEUROLOGY
Entitlement ENET TPA
Insurance card number.ARH-0214-E
9994 Doc Type El Doc No: 784197538628609

CONTROLLED MEDICATION PRESCRIPTION Controlled No

Prescription date 30.08. 2020 15:49
Principal diagnosis M79.2

Secondary diagnosis G56 01, G56 02

Allergies N o Known Allergy

Generic name Brand Name DosélCycle/Route Duration Qty. Refill Qty.

PREGABALIN/75mg/ PROGABA 75MG 10'S
Disp.
CAPSULE Capsules / qPM 30 days 3 BOx
ORAL
Comments for neuralgia due to CTS_
Pharmacy signature

Dr ad Syed
Cosutam NeuroioY
LIC NO.: GD19349
Doctor Name DrSajidSyed.c tnneh
License Number: GD19349

ConsuttantWeuroloEY
Dr.S a t dS y e d

IC N:GO19349 n c h

-|.L..

ospital
AU
. Lifecare1 3 3 5 0 0 ,

P.O.Box:

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AI Ahalia National Pharmacy LLC - Branch 1
Tel:+971 2 55 97 090
Fax: +971 2 55 97 060 Caningly Yours +4VYOo 4V 7 Sl
P.O. Box 2419 Abu Dhabi U.A.E -
:.9P
EmaRNNSR6dDYANEa ~öo0dsl @ahaliagroup.ae Web:AXYNDUieroup.com nationalpharmacybranch1@ahaliagroup.aes
Bill No: 12A07976 Bill Date: 09/09/2020 06:27:00PM Claim Form:
Cust Name: Cash Sale Ins Card No: 1
Patient Name: Dispensed By: Jasina
Sub/Promo: Doctor Code: Pol/Rem:
S.No ITEM CODE ITEM DESCRIPTIONN QTY ACTUAL RSP|REV RsP TAX (%AMOUNT
1 33310868 0123 FLAMING0 CARPAL TUNNEL SPLINT 1.00 35.00 35.00 5.00 35.00
Sub Total Before VAT 35.00 Non Taxable Amount 0.00 Round Net Total 36.75
Discount 0.00 Taxable Amount 35.00 Co-Pay/Paid 36.75
Net Total Before VAT 35.00 VAT Inclusive 1.75 Balance To Receive 0.00
Customer Saved: AED 0.00
Medicines Sold Will Not RefundOr Exchange Signature:
D
Medicines sold will not be taken back
once or exchanged Customer's Signature.
 10/21/2020 Sehleq

CenetO amrup CLAIM FORM

Member's details
Claim Ref.: ECN604398
Member ID ARH-0214-E DOB 01-Jan-1975 Payer: National Life and General Insurance
Name HUSSAIN MUHAMMAD NW: SEHTEQ BASIC Company SAOC AUH
MUHAMMAD IRSHAD MUHAMMAD (ENET 1) Policy Period 10-Jun-2020 To 09-Jun-2021
KAMAL 0 Pol. No. 8000001979 Deductible: AED. 20 for GP& AED. 10 for SP
Emirates ID 784-1975-3862860-9 Co-Ins. MAT: Covered with AED.20 for GP &
Client ARABIA TAXI TRANSPORTATION
AED.10 for SP
LLC-AUH
Medical Section: (To be filled by treating physician)
Presenting complaints ********************

Clinical findings:

Past History(if any): ******"*""*****"*""**""******"****

Assessment/Diagnosis
*************************************************************** . sa ... .....
Treatment plan
Drug Name QIy Dos ge Instructioon

********"*************************************************************suw ressennavunanos s . .
*****" ****"****************************************************************** *********************************************************************************** ..... ..

Laboratory/Radiology Other Procedures:

******
******
*************************** *************************************************************************************e*ns ******a.*o

Doctor's declaration Patient's declaration

confirm that I the patient's medical I hereby authorize the
am
Physician, Hospital or Pharmacy file a claim for
practitioner and that the particulars given are medical services on my behalf and I confirm that the to
above mentioned
to be the best of my knowledge true and examination/investigation/therapy is given to me by the doctor. I
hereby
correct authorize the Physician, Hospital or Pharmacy or any other
person who has
Medical practitionor's provided medical services to me or my dependents to furnish any and all
Name RENUKA SUNIL SUNDARAM information with regard to any medical history, medical condition or medical
services and copies of all medical and hospital records.
A Photo copy or telefax copy of this authorization shall
Signature. be considered
***°'***''***°°**********************|
effective and valid as the original.
Sea/Stamp.. * *****°****'"****""************ ********

LIFECARE HOSPITAL .LLC- BRANCH 1

Important note to provider:
1. Please complete all information clealy Patient Signature.. Date:21-Oct-20 01:59 PM
2. Copies of the same claim form can be used for lab and Pharmacy.
*****************************************.**"'"""******"**** ************"******* ***
Centurion Star Tower- A, 2nd floor, room 204, Port Saeed Deira Dubai
UAE, -

Tel. No.: 04-357-3444 P.O. Box: 116393 E-mail: info@enet.ae Emergency: 04-396-9991

https://pro.sehteq.ae/Provider_HAAD/PrintClaimForm.aspx?cid=ECN604398 /1
 10/21/2020 Sehteq

CLAIM FORM

Member's details
Claim Ref.: ECN604398
Member 1D ARH-0214-E
DOB 01-Jan-1975 Payer National Life and General Insurance
Name HUSSAIN MUHAMMAD
NW SEHTEQ BASIC Company SAOC AUH
MUHAMMAD IRSHAD MUHAMMAD (ENET 1)
KAMAL 0
Policy Period: 10-Jun-2020 To 09-Jun-2021
Pol No 8000001979 Deductible AED 20 for GP& AED. 10 for SP
Emirates ID 784-1975-3862860-9
Co-Ins MAT Covered with AED 20 for GP&
Client ARABIA TAXI TRANSPORTATION
AED. 10 for SP
LLC-AUH
Medical Section: (To be filled by
treating physician )
Presenting complaints

Clinical findings

Past History(tf any)

Assessment/DiagnosiS
Treatment plan
Drug Name
Qty Dos'ge Instruction

Laboratory / Radiology: Other Procedures

Doctor's declaration
Patient's declaration
confirm that I am the patient's medical I
hereby authorize the Physician, Hospital or
practitioner and that the particulars given are medical
services on my behalf andI confirm that
Pharmacy to file a claim for
to be the best of the above mentioned
my knowledge true and
correct examination/linvestigation/therapy
is given to me
by the doctor. I hereby
authorize the Physician, Hospital or
Pharmacy or any other person who has
Medical practitionor's provided medical services to me or my dependents to furnish
information any and all
Name RENUKA SUNIL SUNDARAM with regard to any medical
history, medical condition or medical
services and copies of all medical and
A Photo copy or telefax
hospital records.
Signature.. ******************'********°*'** '**. copy of this authorization shall be
considered
Seal/Stamp..************* ** *** * effective and valid as the
original.
LIFECARE HOSPITAL .LLC BRANCH 1
Important note to provider:
1. Please complete all information clearly Patient Signature.
2. Copies of the same claim form can be used for lab and Date:21-Oct-20 01:59 PM
Pharmacy.
***** ***"*"********* *****"******""****"""*****"******"******"******************
Centurion Star Tower- A, 2nd floor, room
204, Port Saeed Deira Dubai -

UAE,
Tel. No.: 04-357-3444 P.O. Box: 116393
E-mail: info@enet.ae
Emergency: 04-396-9991
*******

https://pro.sehteq.ae/Provider_HAAD/PrintClaimForm.aspx?cid=ECN604398
1/1
 Patient Name Muhammad Irshad Muhammad Kamal,
LIFECARE Hussain
Age 45 years Gender Male Weight 1200 KG
Address Umm Al Nar Tel 971506644719
Patient number 80140243 Case number 8000794043
Department ENT
Entitlement ENET TPA
Insurance card number ARH 0214-E
Emirates ID 784-1975 3862860-9

PRESCRIPTION FORM FOR NON-CONTROLLED MEDICATIONS ONLY

Prescription date 21.1020201451 Prescription1D: 10021742086

Principal diagnosis H60.11

Secondary diagnosis H60 311

Allergies N o Known Allergy

Generic name/Strength/Form Dose/Cycle/Route Duration Qty. Refill Qty.

GENTAMICIN (AS SULPHATE)/ 2
Disp.
Drops/BID (twice daily)/ days
3mg/ml/ DROP TOPICAL
Pharmacy signature

Dr.Renuka Sunil Sundaram

pecalst Otolaryngology
LIC No: GD19034
Lfecare Hosphtal LLC.
Branch
P.aBon:133S00, Abu Dhabl- 1
uAE.

Doctor Name: Dr. Renuka Sunil

License Number GD19034

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