No.

30, JALAN AINSDALE 15/4, BANDAR AINSDALE

70200 SEREMBAN, NEGERI SEMBILAN
Tel: 06-775 8000 / 011-5137 6490
email: uniklinikainsdale@gmail.com
Managed by THRU MEDIC SDN. BHD. (1292046-P)

Date : 12-09-2022
To : Dr Najeeb, Columbia Asia Hospital, Seremban

Dr. / Sir / Mdm.,

REFERRAL OF PATIENT
Patient Name : LEE TZU FEN
I/C Number : 860910595200

I have examined the above patient and provide treatment as per below notes:

Referral Reason :
36/C/F

p/w skin itchiness of rt hand

dry patches with blisters
temporary resolved by topical steroid

Imp: Contact Dermatitis

I would like to request your kind service to further aid the patient.

Thank you.

Signature :
Name of Medical Officer : Dr Siti Syuhada Binti Yusof