pe PAUL EULA GU RS Pe ey PETC Dy ] | | SURAKSHA KIDNEY & MATERNITY CENTRE trol Bunk, Bondlipuram, Srikakulam - 532 001 OR cee APP RRR ea) Emergency : 8500 32 34 36 Vane | sD Gus oa CeaANTENATAL RECORD erL B « Re: ‘Husband's Oce: Wife's Oce MH 13/30 Rime Insurance Previous OBS History : pe DT LMP: 29°04-202) TEA: EDD: $/>/2) Tre 5/6 tots | ou} a By, 25 De re Jo 6 a Past History : — Family History: — GE: cvs: Lanes te eal Investigations: Blood Group : HESAg: —We se. Ceealintno; HV :-Ve ScBilimbin > ‘DRL HCV : Ve Date ba tor3 Insicct | 41 he nib SPECIALTESTS Early PregScan TA Growth Scan iensen NT Scan (11-13wk) Double Marker (9-13wk) “Triple Marker (14-20 wk) Foetal 2D echoLg GOOD HEALTH TPA Plot Ni 2, Ble -k -S, Okla Industrial Area, Phase-2, New Delhi-110020 Website: www.ghpltpa.com Checklist for Reiumbursment documents:All documents should be in original. Aen cada ay frp PATS ed (Carcled Choe wih pe-pined rane Copy of estan «po sei dsctor rd vanserype Compl {ccm Hobe ey dana Bek arya sey tn bank sinter are antsy ~ Sjpocess). Note ety provid) Rectan Cait ol espa x acai Fo Ue ap ching vias Goals e Nor of Bats, rey Ale Dutt 8 Nuss ud he eck Operant et ‘Hija er an ele DN eat wp ly ied and strep nd baud. glee charge summary wih Days ,DOA, DOD and Deano eatnet uy Sadana stpedby ‘veaing doctor and Insured, [oigral mbes ech dy sed nd samped by hap opal ral bi andnsued, ‘7 tla ogl parts ands Postv leant invesigaton rps supa oan 7 sgl Prescipinabising ests ading mens, and surpotg cosinor ame bis. [Olas const paper [> fest Hat al en Re acters z B50 Days Pre 86 Days Pos hsplalzlan (Except ali) ‘BlOrial Sicerendlnae ce tnplailensused (apa) ‘hn an ere a aise ep, awe 14)useaton forth same Copy of caiman. 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Pag Na Ener be eae aber 7s aed ye nsrance Company ‘Str Coats Na Err bo sansa REO Tele DT oT {As lot by tw erpancaion| Company TPA ING Ena te TPAIO Na ‘Teatgnrmber a ate by RDA wr pied L i t t —— a Err arone ft plo Suman Fstnane Mera cc Erie fl pox es Tnclode Sto Cy ad Pn coe i SECTION 8 DETAILS OF NSURANCE RISTORT Tp eae tema ‘hte are oma ober NSTGIRT | avr i a ol concen nan wiht emak | Ere dalle eK NS Das anoyrormat Coney Nae Ener toa ol ance Company Nae ofthe cmancatonia A Pat ‘Ener lyon 7s aoiedy ie snc Coney Smewan Ero len nso por EY Trnpees FSS ESN TOTITINS [scan aero nas ow Tecverarte Os _ ‘Earned ol apt Veer Torat Boga Eero gnats dis ‘pene Ree aT REST EG ate Po ORTH ORS es ar ore Err a none he Pas CONF Tomeol De opeanA 'SESTON GDETALS OF SURED PERSON HOSPTALRED toe Erie nana lh abet Sorome Fesinane idan —_ Ingen Gas on at “Tesi or Feral ase Eee ag ft pent Nee ofa ns ra Bnet Erie Ose Sh loston Vee gen fora 2)_ Restor onan ae Tnscae resins of ple wh paler “Tes rah orn. CG RON 1) eesipaen seve econ pet “ke ah oton etre Bens spe 2) Basse Eni oa 5 Ince Sv Car Pn cove 21 Pree Ener ore eer of Rint Tine S10 co wh phere OTE ewe Ena oma aon often Congo ona cies ‘SECTION D-DETALS OF HOSPTALITOW _ ieee Ener noe fe Noe ahospba nha Reser tego Teal cae Sig Tike rah oston 3 peiaton eo Ines ese ol epeaon Tek Feopan 3s tic a TL THRIRTORT Taranoaian alesis 2 Dat of sonion edt of omen Tacoma Tee a fats inaeee 8) One aeons Eo st of seb {Use nm oma 1) Tine Erne ase Use Rot Why ge ae Tadeo ene iY Tee ra oR edo aa reas wae moet Tes or art ale Tricata wt lea oot wes led ae Mi Repo Pica tached cna wart WLC ped Pot FR atasied rakes or j reer eee Soe eo ‘SECTION E DETALS OF CLA 3) Dv Teoment panae rr aa a as sient apres Tones (onl enb poe a) 3) Some Oomciny Horatio Inst water om ot aia saan Te oso 2 Det of ump sun Cash bon. dard Ener th aa ded ak arp sum cash barat @)_ Gaim dosent Sates Check Lit ‘rat hl spar decane ae sid \erpees (Do toot pase vee) Tok ha phon Tele Wich os re coed i ih OU ‘SECTION F-OETAILS OF BILLS ENCLOSED ‘SECTION G DETAILS OF PRWARY INSURED BANRAGCOUNT Ent th pean Seo ar Bs eid rhe are Ta Dopo 3) Aerator Seeeieaeet eee A aslod be a nn Bar ae ro See Bank Na nd anc a rao ha brea Be aque TOO OATES ©) Chew 00 pate dats rast Nave pa neha pen a a) FSC ome Ener ti FSG cde ots rh Deh Tac ea oe one ‘SECTION H- DECLARATION BY THE NEURED ewan cry and ro a Fea) ae (open te od 30SIE a, = retoitactseitciacir meray ose SSR@ETERUEDSHEFEEAneOeOeeOOeeEoEcooUoo ld « OOoAepoOoo Sete — tent} tant: Canon tn § gute ae BABES EOURBACOOUEROOMsaOoeCeeoEooeoEo 3 wan MB(OKG) Timorese WAITIGEIION oo ISI AEIGEEGC * ALS oF THe paneNr ADMITTED pewter SAUTE EARARAIEPeER ee eOReOOeoeoooo [clealm) Prostar SHES EC ISIY yee use] ronan oon DG oH sone OE Ae) , pevtoee FS 8 AO ame AS GE) ncnwoer SE IW am. Bl fle) 8 Preatonaes tooeer(] Pmt] owcweC] wan — ttn pomclower IS] (BE) ILE) nenaame, IE) 2 Sits sectdatae: Oschgetnone E~ Oscgetosetr tsp CJ oases Toa coed ant a@aaya0 TAILS OF AILMENT DIAGNOSED (PRIMARY) Dons nite ¥ ‘comes rents OOOOO00 Se $8) [eee = OOO00O00 wero: OOOO vec: GEES! omy tes seemme OOOO000 seewes OOOOO0O roms §$OOO0000 bse eeutaatony tro tad, as } Hemacaerenvney Ce Bie urea satin] steht Cece ttc niente saul aehdemnreen xcmbecsoemaani: C]s EM Wreath atest: Cee C] te reponse Clie C] no | we OO DODD OOD — stamp epta gems | CLAIM ocUMeNTS SUBMITTED -CHECK UST Bein kaa od | ee) C1 crunusanes mnstsea pon Axe eerste ponte D_ decors tec forstston | “EX copa cotcteset eet O os AT Weptbsagenenay GY Prova EE Ses Ns Mews rsere TP testmannt Cette vn ate EF toning ere ADDITIONAL DETAILS WN CASE OF NON NETWORK HOSPITAL (ONLY FILL IN CASE OF NON.NETWORK HOSPITAL) | | oeielc ee g EDOPEDEASOOPweAeOoODooooOOooooOOoOo HUEY MES RMgaC cc IO SCO CEEOOOS cee | * DEGEREOOSECOOOOO TiaeoOAeaaooGoO00 & eee AIO ven MOOREA? cmmeeoe EIOSIOUOO0 dro — OOOO OOO omewdtienes FBI] sreteonisnneets or Fie Ore wc fie One over E J g g 2 fomsomeranne OF O grata OOOOOOOOOOoOg | 3 i (aR ser carer sapniatineTeaeTA. : Vena de ine matin natn iCal Fomine coe tbls tel hoe ade yarn sa ‘serge be dames eet = 76 2 oA Si add gy CehieAKiedy ——_! ME 310225 SENN 3 WOULD ierr ee {GUDANGE FOR FILLING GLAMFORU PART (To be edn byte hosp DATA ELEMENT DESCRIPTION FORMAT SECTOWA-DETALS OF HOSPITAL ‘Name ofthe hospital: ‘Enter ve name of hospital pre ‘=a er rae ew reat TPR [ype ct Hal Tracie whethar hwo or non network hospi Tike igh opto [Cian sing dor Girton de tare ar Nae of or ht L_ uatfcaton [Enter the qualécation ofthe treating doctor “Abbreviations of educetvonal quabticatons oo Cae ae rea | M ey bee Car Ta [Peete Ena pone ter door Tle STD ene we ane uber GESTION DETALS OF Te PATENT ADMITTED i Eerfa rene Te ci 5 Primaria Eicon a aaa Sd aaa Govt Tesoro oie Ei nk (nae pees a ona Sie ac ita rat bana aoe Te i a_i uta iii ja tara Soe : ia te rn ete — eo abana meee © Tia [omen iT —t toma Earns fy isc a i komma eae eos Whale Te el nef ome ry | SECTION DETALS OF ALMENT IRGNOSED PRIWART) oe ea ae a [a pe Faria Wat eecnate saint apatt—| tenndfratod pee [ene 6 els Greets | Saad Fare pie Sears [tenant Tao women tape | Sra etapa Fad aa Ga are ie eae | Woden 7 Se pena Ear edanh ipoma a sain Tat be et ad Ta 3 pean ed uae Se a ae regen iy ane Ce Tecate aegis | mentors jain eggs Inet haber ema Teves erno Ret Te ed — fie Zi iia a Tat gaa pac Barner pan = Seco CLAM oocomeNTs SURMTTEOREGR ust Tia pt a SETI E BETIS WERE OF NON RETWERR HOSTAL 3 i a Sees ete Tere mera ceo SP [9 neem cnanen __| ae Rr TTT ceo ormeia rn 3 rap tera pans eor an ——— 2 Rn dip So = = 1 Fai abl tee cio oe SECTION F- DECLARATION BY TE NOFA eae aa apd eee haley| [Creritor) 1FFCO TOKIO General Insurance Co. Ltd. | CHALLA RAMANA MURTY AGE: 28 EMP ID: E6884 GOOD HEALTH 1D: G51510400038387 VALID FROM: 01-07-2020 CORPORATE NAME: NBCC (INDIA) LIMITED 6 Good Health Insurance TPA Limited , _meceeenanepeatainlenee nner (ratio) IFFCO TOKIO General Insurance Co. Ltd. | are PALLI VENKATA RAJYALAKSHMI AGE: 24 EMP ID: E6884 GOOD HEALTH ID: GHIT0400038391 VALID FROM: 01-07-2020 CORPORATE NAME: NBCC (INDIA) LIMITED é Good Health Insurance TPA Limited Te ane of 2 card dome rch parc crane Ponta. aia od, Setincoreos 30005, Toangena, mee Good Health Insurance TPA Limited ca iy Home Cra Ate Brocbal Chamba, se don seh, 4 Pls et Seda Ssee Cl asd Qesgor—* ~ ©€ Government of Indian Bartow Palli Venkata Rajya Lakshmi @4/DOB: 04/01/1996 6006 0362 2773 BT: EX. Bs 03g ogQo~ FOSS dog a ~ Unique Identification autho of India Sarr: D/O vay, 0-322, von5 5, offer, roo, sooo, Gog 385 - 532484 Address: : D/O Apparao, 1-375, main street, Ragolu, Srikakulam, Srikakulam, Andhra Pradesh - 532484 udeoroud uw 0709 4« e Cr org aay ere * e& © Government of Indiamanewr>-* Challa Ramanamu: ar ty Date of Birth/DOB: 12/05/1p92 Male/ MALE 2405 5186 0299 SRT sene, FW AeaeT AN ~ @{Unique Identification Authority of India” Address: S/O Yerrappadu, 1-142, Main Street, Main Street, Ragolu, Srikakulam, Andhra Pradesh - 532484 2405 5186 0299web99T0ng eee He ee wo - wo FORM-VIL [See Rule 6] Government of Andhra Pradesh Health Medical & Family Welfare Department District Registering Authority Certificate of Renewal of Registration of Allopathic Private Medical Care Establishments Apphcabon No and Date 140.1.28-09- Dok eR (Onginal File number of Registration Authority 20 ee _ Dateoftssue ofthe Cerificate of Registration 2 8.09 - 2 O16 Date of expiry of the Certificate of Registration 271. 09.- 2016 _ — Date of renewal ofthe Cerificate of Revistration_2 &- 09-2016 Renewal of Cemuificate of Rey:stration validupto_ 9 J-09-202) ‘This is to Certufy that the Certificate of Registration issued to. DY: K. SARITHA- Ms SURAKSHA KIDNEY & MATERNITY CENTRE hcatedat SRikaku.Am ishereby renewed under the provisions, Of A PAllopathie Private Medical Cure Establishments (Registration and Regulation) Act, 2002, to provide following medical care services: © BASIC, General SURGERY, UROLOGY WW GYNAECOLOGY, GEMERAL MEDIONES ALL SPECIALITY SURGERIES This Renewal of Certificate of Registration shall be in force for a period of 5 (Five) years from the date of issue. This Cerificate shall be produced whenever itis required tothe officer authorised by the Revistraton authority, ). The Establishment shall not rent, lend. sell, transfer or otherwise close down the without sheaining prior permission of the registration authority. . Any unauthorized change in personnel. equipment or working conditions as mentions in the application by the Establishment shall constitute a breach of registration The Establishment shall not violate the provisions of 4.P. Allopathic Private Medical Care Estublishments (Registration und Regulation) Act, 2002 as amended from time to time and the rules made there under. This Cenificate is subject to the conditions and the provisions of the 4.P AUloputhic Private Mexticut Care Establishments (Registration und Regulation) Act, 2002 Genetica! 8 Fy S Hany ze Ss eH, “0S Stensture sh Name or TES 0 istrict REBANcrINE Aware, 4 Dist. Medical A Heatta Ofricee ce oe Smmaeota, %e-,-p/ Roa [p/ SAiKacuLam. %“Aju sno4 3xIS pubsnoy, Ary613 : sp1om uJ JunoWYy (00°79008 IWLOL ONWYD loo'o06z Tz02'90'97 vL loorezz TZ07'90'L7 Zestoov loo"toz TZ07'90'LZ ‘Q9TTSZOSIESTST looeet TZ07'90'87 ererszossestst | . loo'eot TZ02'90°87 BTZTSZOSESTST sig qeeuipan/Aoewueyay — Z loo'666 TZ07'90'87 6LTSTOOSISITVT 100"00L TZ0Z'90'8Z Lt (00'009 1707'90°0E iL loo'se0z TZ07'90'0E ST9TOOV Teer and ae (so8:eyp aulsipaw’se31ey> . Taorremae ae SZ | gusinn ‘quay wooy ‘se#eY9 ND! Tz0zLO'TO 307 90°82 -_ 9 | yuay aneayy uoneiedo ‘s982ey9 oo'OSsTZ a Tega ar nepe0! ow ‘soBieysasnamnseeuy| tzoz'90'9z | TZ0Z'ZO"TO paxep STOTOOW “saseyp uoaing “jul ) - ON sir ans) sina WIEW [eudsoH £26 : ON a8eq 820912J8Y (sy ui) aed ON a/owaw yseD spiemoy/uonduaseq on ‘Is [spewed SIE SEISP WEP 10} SING [ESIPSTA FO AreurtaNS ®) be aeon y we (SS Se — Set SURAKSHA KIDNEY & MATERNITY CENTRE Opp st to. Bharat Petrol Bunk, Balaga,SRIKAKULAM. Ph : 08942 229933,278222 Regd No: 210 DISCHARGE SUMMARY Patient Name — ; Mrs.Palli Venkata Rajyalakshmi F/24yrs Date Of Admission: 26-06-2021 Address, W/o Challa Ramanamurthy, Date Of Procedure :27-06-2021 Ragolu, Date of Discharge : 01-07-2021 Srikakulam Dist. TP No: GYNS52662021 ‘Surgeon +: DrK.Saritha MD.(OBG) Disanosis --: G2PL1_ with Term Gestation with PCP in Labour. Investigations: Enclosed Treatment —_: Repeat LSCS (Caeserean Section) + Bilateral Tubectomy under Regional Anaesthesia Case Summary : The patient is admitted with Term gestational age with labour pains.She is Known Post Ceserean pregnancy Repeat Cesarean section was carried out without complica- tion, Delivered an Alive Male Baby as Vertex on 27-06-2021 at 08.32 AM.Baby weighs about 2.75 Kgs.APGAR 8-10.Bilateral Tubectomy Done. he patient did well postoperatively. The Baby did well postoperatively. The patient is ready for discharge to home. Status On Discharge : Stable Advise At Discharge : 1. Tab Zericef'S00 1-1 xSdays (10) 2.TabDolowin Forte 1-1xSdays (10) 3, Tab Rabilast-D ~1-x 10 days (10) 4. Syp Immustar 2 tsp daily twice 5.TabNurokind LC 1x 10 days (10) 6.Tab Chymoral Forte 1-1x7days (14) 7. Tab Limcee wi-xSdays (5) 8, Oint Neosporin ‘9,Continue Iron & Calcium tabs for 1 month 40.Maxpro Powder 2 tsp in Glass Milk twice daily ‘Dt. K GARITH, H.0, (Gy) _— Reatt Noqf0798 raha ac SM erininpCentrs SRERARULAMCASL/CERDIS BILL SURAKSHA KIDNEY &@ MATERNITY CENTRE Opp.Bharat Petrol ‘Bunk,Balaga, Industrial Eatale,Srikakulam.Phi 00042 220093,2 i222 Bill No.: 923 Propx : Dek Salthi cine eee Patient Name ;Mrs.Palll Venkata Rajyalakshmt ®/2A yen Adralasion Date ¢ 26/06/2021 20:00 Address: Wo Chaila Ramanamurthy,Seikekulam Dial, Discharge nto ; 01/07/2021 20:00 LP No. : GYNS52662021 Ward/Hhed No : 313 SINo. Particulars Amount 1 Surgeon Charges fw, 18000,00 | 2 Anaesthetist Charges 4.4500.00 | 3 RMO Charges 4x 1000 84.4000,00 4 4 (Operation ‘Theatre Rent fe, 000,00 5. ICU Charges 1 x 7000 £s.7000.00 6 Room Rent 4 «4000 £s,1 6000.00 1 Nursing Charges 4x 500 s.2000.00 8. Medicine Charges Rs.12050.00 Total Rs.71,550.00 Dicounts /Rounding OF Nil Grand Total Rs.71,550.00 = In Words : Rupees Seventy One Thousand Pive Hundred Fifty Only. Receiver’s Signatureny 100 Zeg-wRIAge Le ‘eam yas ERD ae swoldaw apeenata WHSMYANS.. 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(nw ‘npndefumusyg "yd" SOLLSOND VIG VHSHY Ikys|se 190 bz “onmagmail @ any damage caused by the limital il.gov.in/b/printmessage?id=C:-46978t2~Asia/Kolk.. { CHALLA RAMANAMURTY Support Ticket Opened [#C2156503] From : customer care Wed, Jun 30, 2021 10:10 PM Subject : Support Ticket Opened [#2156503] To : CHALLA RAMANAMURTY t Dear CHALLA, A request for support has been created and assigned #C2156503. A representative will follow-up with you as soon as possible. Your Good Health Insurance TPA Services [Customer Care] Team, Support Department If you wish to provide additional comments or information regarding the issue, please reply to this email This email message and its attachments may contain confidential, proprietary or legally privileged information and is intended solely for the use of the individual or entity to whom it is addressed. If you have erroneously received this message, please delete it immediately and notify the sender. If you are not the intended recipient of the email message you should not disseminate, distribute or copy this e-mail. E-mail transmission cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, incomplete or contain viruses and no liability is accepted for tions of the e-mail transmission. 7212021, 8:07 PMlof! |hupsdfemail gov.in/lprintnessagctideC-460S8te~AslarKolk ail : CHALLA RAMANAMURTY intimation regarding medictaim of maternity i.r.0 P: .t.0 Palli Venkata Rajyalakshmi, W/o Chall _Ramanamurty, £6884, NBCC (India) Limited. _ ae | From : CHALLA RAMANAMURTY ‘Subject : Intimation regarding mediclzim of maternity i.o Palli Venkata Rajyalakshmi, W/o Challa Ramanamurty, E-6884, NBCC (India) Limited. To :customer care Wed, Jun 30, 2021 10:05 PM a2 attachments To, Good Health Insurance TPA Ltd. Plot No.2, Block -S, Okhla Industrial Area, Phase-2, New Delhi-110020, 4 Subject: Intimation regarding maternity medictaim of Policy Number H0329135. Respected Sir/Madam, Tam Challa Ramanamurty regular employee of NBCC (India) Ltd and employee id Is E6884 and I do carry policy of your company having the corporate policy number H0329135 in the name of Challa Ramanamurty, Good Health ID is GHIT0400038387. I Would like to intimate you that my wife Smt. Palli Venkata Rajyalakshmi (Good Health ID: GHIT0400038391) is admitted in Suraksha Kidney & Maternity centre on 26.06.2021 at 5.30 pm with 39 weeks pregnancy and she has undergone cesarean operation/surgery at hospital on 27.06.2021. Estimated date of discharge is 01.07.2021. Kindly consider this as an intimation letter for the mediclaim purpose for Palll Venkata Rajyalakshmi. Tam hereby attaching Medical Card of both for your ready refetence please. |, therefore, request you to intimate my insurance company so that my claim may be settled in due time. Orginal bills, Discharge summary, medical prescription, lab test reports, pharmacy bills along with claim form will be submitted to your good office post Discharge of my wife from Hospital. Thanks & Regards Challa Ramanamurty, Project Executive (Civil), NBCC (India) Limited. | ‘A Govt of India Enterprise (under Ministry of Housing and Urban Affairs, Govt.of India) Jackson Gate, Lenin Sarani, Agartala, Tripura. ‘Mob.No ~ 8132954076 Email ~ cr.murty@nbecindia,com .— USG report PV Rajyalakshmi-LQ_image_only.pdf 1,008 KB _— Good Health TPA Cards-LQ_image_only.pdf 312 KB 7/2/2021, 8:09 PM aOpp : Balaga Bharat Petrol Bunk, Bondlipuram, Ee eo ee aah DIAG WN Oo T 1 Patient Name :Palli Venkata Rajyalakshmi F) Date:26-06-21 i RefDoctor : Bek Sartha MaoeS) _ REPORT aah VALUE STANDARD VALUES COMPLETE BLOOD COUNT = HB% 102 gms% Fe it-l3, Mi AF-I6 _ os 8300 cells/cumm TREC 3.13 millions/Cumm Haemotocrit 70 % my 863 FL MOH 297 Py MCHC 4 Gol Platelet Count 2.32 lakhs/Cumm Lymphocytes 28 % Mixed Cols 82% Neutrophils 640 (9 xn0c221 Heaton tape) Random Blood Glucose 112 mgs/dl 75 to 140 Serum Creatinine 1.00 mgs/dt ‘F: Uptol.2 M : Upto 1.40 Blood Urea 22 mgs/de upto 40 Serum Biiubin (Total) 0.68 mas/a upto 1.0 WNon- Reactive Non- Reactive Non- Reactive Negative Lab BeOpp : Balaga Bharat Petrol Bunk, Bondilipuram, EUR PAUUL Parana KER) DIAGNOSTICS Patient Name :Pall Venkata Rajyalakshmi F/25 yrs | Ref.Doctor: Drk.Sartha.MD(OBG). meee I ‘REPORT TsT VALUE Urine Examination: Protein Traces Ghucose we ‘Microscopic Examination : Pus Cells 2t03 TE Epithelial Cells 3105 [PF cs RBCS Owl /HEF : Casts & Crystals 7 ‘06 Thus Report ls not valid for Medico legal cases. vistMS (22868 496), M.Ch (amered) Bi boctangimons ayn o84,n500 20. 36290 Name 8 N+ Bod Yolakeann DwHE 2,sp9S wie od Ce een ay eae DO eee eee ag ADDS 83,6 soe, wow es Age 2.2. .sex..-..Weight@S-Date... 612.) Ghee tik & no couphenly Ae FS & _ use ai 2 Pee ooa) HPL MDINDIA, VIDAL (TTK),RELIGARE, RELIANCE GEN, MEDICARE TPA, HEALTH INDIA, VIPUL MEDI| Sao" re Ca,L, T Umoukta & Pep: ; nyo courpleznly | art JE monly | fla-(e owes (Q) antig 84, « mee, a0n6 i obo 36200 ? pod HALOS Gu 5. 00S anes ny | B85 : (08942) 229933, 652270, 8500323436 eh ay G4) Lie media ei rons én Lea pate al uk 2Y Lok, a . oat a ue _ Adgs Dy Aral -% “t 1 [deg® “th. felipe a4) ‘On “bh. ws -P, | tb. Bove - ae (> SOBSAE ebay aBlyoow, OBS adiyvot har sabonByows REpG0, Soro. . HEALTH CARDS ss ; wali lone pl | Repmeemotenegetgnce ots OS DIKE DOB art Hot, BOSRIS aH. EHKCO QR as S48 Date 3/612. \ “— FBO — OF “SS - We igen pe ousdew © (FHL, GHPL, MDNDIA, VIDAL (TT, RELIGARE, RELANCE GEN, MEDICARE TPA, HEALTH INDI, bbs_ GB. Hrvoadintsy 6 No pcan if Aug 8G, « aée,) 708 Br B. HOS HR5b wpPoB mee a ee 065 emis 208 aXinto BOGD, BOBZT ai = eee 229923, 652270, 8500323426 11-37 pry Name :. PV. Faia lode shan ee bef L, & Amend Ghz pep. j No comp beenly ere BY PS 8H eae Weigh a) pla - Uk Bovk- sabhgal Cobrebe PK © COWEEE Bare, ath yoow, CBE OB fet ber bchon’ Dol Fo Sot. HEALTH CARDS ACCEPTED (TTK, FHPL, GHPL, Md. INDIA, etc.) ea YeQuash” aque? CRl, © Ab moudty CA \W« \JAYUDU HS) ~ Suraksha Kidney & Maternity Centre g % SUPER SPECIALITY HOSPITAL bos teen) Opp. Balaga Bharat Patrol Bunk, Industelal Eutata, SRIKAKULAM - 532 001 | OnNTE TRICIAN & GYNAT GOI DUI Ph : (08942) 220933, 652270, 8500323436 fa Nanpaitient NamePMRajyalakshmt-F/25yrs: 1A 80% inne, Wolght - Dalfabe108-05-21 Ref,Doctor : DrK.Saritha, MD(OBG).. | REPORT | TEST Value Standard Values Complete Blood Count: 18% 10.3 gms% Fr 11-13, M: 13-16 Twec 9900 cells/Cumm 5,000-11,000 TREC 3.45 millions/Cumm F:3.9-5.6,M 45-65 Haemotocrit 27 % F : 6-47, M: 40-62 Mev 86.1 FI 78-94 MOH 29.9 Py 27-32 MCHC H47 Gol 30-36 Platelet Count 246 lakhs/Cumm LEAS Lymphocytes 240% 35-45 Mixed Cells 61% 515 i Neutrophils 69.9 % 40-80 j (By Sysmex KX-21 Hematology Analyzer) a@h% Random Blood Glucose 91 mgs/at 75 to 140 Serum Creatinine 0.80 — mgsfdt Fi Uptol.2 M : Upto 1.40 Blood Urea 19 mas/dt upto 40 Serum Bilirubin (Total) 0.81 mgs/at upto 1.0 HCV Non-Reactive "* This Report is not valid for Medico legal cases. ib irge Referral Hospital for State Government Employees & Pensioners HEALTH CARDS ACCEPTED (FHPL, GHPL, MOINDIA, VIDAL (TTK), RELIGARE, RELIANCE GEN, MEDICARE TPA, HEALTH INDIA, VIPUL MEDICORP, LIBERTY VIDEOCON, etc.) 7 aS.. General Sur . Dr. K. DHANUMJAYUDU. t ™ gery MCh. Urology (Osmania, Hyd ) UROLOGIST & ANDROL OGIST Regd No 36280 Dr. K. SARITHA MD (8G & Gynaec) eet OBSTETRICIAN & GYNAL COL OGIST Regd No 40708 TIMINGS : 10.00 a.m. to 2.00 p.m. & 5.00 p.m. to7.00p.m. Sunday ‘Name :... Suraksha Kidney & Maternity Centre a] SUPER SPECIALITY HOSPITAL bee Opp. Balaga Bharat Petrol Bunk, Industnal Estate, SRIKAKULAM - $32 001 Ph : (08942) 229933, 652270, 8500372426, Age Patient Name :P.V.Rajyalakshmi _F/25yrs RefDoctor : Dr.K.Saritha. MD(OBG). ie wd REPORT Test Value r Oral Glucose ChallengeTest Random Blood Glucose 91 masfat Urine Glucose ww Blood Glucose 126 mos/al Urine Glucose Mw ‘After 4 br Oral Grease Intake of 50 gms Urine Examination: Protein Ni 6% — Microscopic Examination: Pus Cells 2to3 HPF Epithelial Cells 4106 HPF RBCS Otol /HPF Casts & Gystals Mw nn SOK errr ere Werght : Normal Values 70 to 130 Upto 140 Date Date:08-05-21 (FHPL, GHPL, MOINDIA, VIDAL (TTK), ** This Report sRefetrabHospitaldorState Government Employees & Pefisioners HEALTH CARDS ACCEPTED RELIGARE, RELIANCE GEN, MEDICARE TPA, HEALTH INDIA, VIPUL MEDICORE, LIBERTY VIDEOCOM, ot.) DCU or reM.A, Urology (Oxmanio, Hyd) ee Peace mR] Suraksha Kidney & Maternity Centre §) [eae cere @ SUPER SPECIALITY HOSPITAL bua De PTR, cand Opp. Bataga Bharat Petrol Bunk, Industrial Estate, SRIKAKULAM - 632 001 ' OBSTETRICIAN & GYNAECOLOGIST Ph ; (08942) 229933, 652270, 8500323436 Regd No 40790 LIER Pe ee Rs ee ‘Weig! Name Date:08-05-21 Patient Name :P.V.Rajyalakshmi_F/25yrs Ref,Doctor : DrK.Saritha. MD(OBG). s REPORT Test Value Normal Values Oral Glucose ChallengeTest Random Blood Glucose 91 mas/a 70 to 130 Urine Glucose ww Blood Glucose 126 mas/d. Upto 140 Urine Glucose Mw ‘Aer 1 hr Ora! Glucose Itake of 50 gms Urine Examination: Frotein nt yD — Meroscopic Examination: : Pus Cells 2t03 HPF Epithelial Cells 4106 /HPF RBCS Oto1 /HPF Casts & Crystals Mw ** This Report sRefetrabHospitalorState Government Employees & Pefisioners HEALTH CARDS ACCEPTED (FHPL, GHPL, MDINDIA, VIDAL (TTK), RELIGARE, RELIANCE GEN, MEDICARE TPA, HEALTH INDIA, VIPUL MEDICORP, LIBERTY VIDEOCOR, atc) | PICU 10 ett ttees a aeditya Scan Centre & Day & Hight Junction, Srikakulam B. Lava Kumar Contact @ 9440672673 MO. OMA Digital X-Ray ee. Name ; P.V.Rajya Lakshmi AgelSex; 25/F Ref by Dr: K Saritha M.D (OBG) GRAVID UTERUS ON COLOR DOPPLER LMP: 29/09/2020. LMP GA: 37 Weeks 2 days. 6 SS Single, viable foetus in Cephalic ROT with active Foetal movements noted. Foetal 4-chambered cardiac view shows no evidence of septal defects or anomalies. F Heart Rate recorded on M-mode and color Doppler shows 150 beats per minute and it is regular. Foetal Skull bones, spine are normal. Foetal both kidneys are normal and bladder is well distended. Foetal stomach is well filled with fluid and no evidence of artesia. Placenta is located in the Fundal Posterior wall Grade II to Ill maturity. Color flow and Spectral pattern of the cord is normal with two arteries and one vein seen. Liquor is adequate in quantity with Amniotic fluid index measuring 12.16 cms. Cervix 3.3 x 2.4 cm with internal os closed. Foetal parameters are as follows: - BPD : 91.5 mm (37 weeks 1 days) WEIGHT; 3097.0+/- 465 gms. HC; 326.4mm_ (37 weeks 0 days) AC :328.3mm_ (36 weeks 5 days) FL :72.3 mm (37 weeks 0 days) UISEDD: 08/07/2021. IMPRESSION: * Single, viable foetus with cephalic presentation with ROT corresponding to 37 weeks 0 days +/-1 week. *Spectral pattern in umbilical artery appears normal. Dr.B.Lava kumar Dedicated to Diagnose... M.D,D.MRD TATORR aal Te Bi aera rcr re ba EeOpp. TDP. LP. Office, Aditya Scan Centre few ser Hoe, & Day @ Nege Junction, Srkaectom Cortact © SAMA TISTZ Dr. B. Lava Kumar i Mo. OMAD, Digital X-Ray Regd Mo. - 85 Comsieant Rathore Name ; P.V.Rajya Lakshmi Dee: ep Zt AgelSex; 25/F Ref by Dr: K Saritha M.D (OBG) GRAVID UTERUS ON COLOR DOPPLER LMP: 29/09/2020 LMP GA : 34 Vieeks 4 cers - ww Single, viable foetus in cephalic at present with active Foetal movements noted. Foetal 4-chambered cardiac view shows no evidence of septal deYecis or anoraiies. Foss Heart Rate recorded on M-mode and color Doppler shows 144 beats per minute and it is regular. Foetal Skull bones, spine are normal. Foetal both kidneys are normal and bladder is well distended_ Foetal stomach is well filled with fluid and no evidence of artesia. Placenta is located in the Fundal Posterior wall Grade Il to Ill maturity. Color flow: of the cord is normal with two arteries and one vein seen. Liquor is just adequate in quantity with Amniotic fluid index measuring 8.86 cms. Cervix 3.4 x 2.3 with internal os closed. Foetal parameters are as follows: BPD : 85.8 mm (34 weeks 4 days) HC; 309.0 mm (34 weeks 3 days) AC: 302.7 mm (34 weeks 2 days) FL: 67.4 mm (34 weeks 5 days) WEIGHT : 2453.0 #/- 368 grams. U/SEDD: 06/07/2021. IMPRESSION: * Single, viable foetus with cephalic presentation at present corresponding to 34 weeks 4 days +/-1 week. “Spectral pattern in umbilical artery appears normal. * Liquor quantity is just adequate. Dr.6.Lava kumar M.D,D.M.R.D Dedicated to Diagnose7 Crake PMR CO aa Pe ee ~ aoe ny rE Pe Ee a Ceri Tt SIEMENS AUTYASCAN CENTER KLM eT Poni ae Ee ee Sr* SONIC HEALTH TSP te lt FI clk AL da cal ML ella WH, Mis MO N88, Colonel Chowmuhanl, Agartala 79900, Wo! pura Phi 232 » 2567, Mobil: 0 91912 07399 Te ance cs Meta never 120 sata Email; sonichre(«2ginall.com ENROLL NO : 201123/ PS NAME + Smt. PV, Rajloxml , 24 YR8. ADDRESS : Bordowall , Agartala. REF, BY :DR,ELALODH, MD, PGIMER , FICOG , FICMCH , FICS (USA), CONSULTANT OBSTETRICIAN & GYNAECOLOGIST - ADVFOR ;USG OF WHOLE ABDOMEN with FETAL PROFILE . DATE : 23.11.2020 Glinicol Note : LMP ~ 29.08.2020 , FA~7 vik 6 days, EN-EMLA. OBSERVATION LIVER : Liver is normal n size and contour, Both right and kel lobes of the Fer sho hemnercns ete opale and portal vossos ero normal No focal hepatic lesion noted . No evidence of ira hepatic Bary zion soon, Gav G,B, : Normal size , well not thickened and lumen is echo-fee. : Tho common duct and portal vein are normal in caliber , 0 part of CBD. SPLEEN : 8.49 cm in long axis , homogenous echotexture , echogencity is normal. No focal splenic lesion noted - The splonic vein is not dilated . PANCREAS : Normal in size and shows homogenous echotexture . No focal abnonmality detected . The main pancreatic duct is not dilated . - Lt Kidney - 9.34 on —___- KIDNEY : Rt. Kidney -8.68.0m Both kidneys are normal in size and echopattern . No evidence of any callus, cyst or SOL seen - | URETER : None Is visualized well. {LBL : Nomaly filed with urine, well gular, no focl thickening or any grovth fom the wall seen . There is n0 intraluminal calculus . UTERUS : 9.23 om x 7.09 cmx7.23.cm , anteverted . Myometrium ~ Thick non-homogenous ‘shows an hypoechoic ‘almost isoechole anterior wall lesion (4.12.0m x 3.99.cm )-? myoma . —S The uterine cavity shows a double walled gestational sac posterity of average diameter, GES = 3.07 om/7 wks 5 days +! O wk 4 days. An embryo is seen inside the sac having embryonic movements & heart action . HIR = 147/10 beats / min . CRL= 1.18 om/7 wks 3 days +/-Owk4 days. = Average GA = 7 wks 4 days +- 0 wk 4 days. EDD = 08.07.2020. Parametia - free CERVIX & VAGINA : Appear normal . i ‘ADNEXA: Right ovary:2400mx202em Leftovary :3.17 omx1.98 om Both ovaries are normal in size , none contains any cyst or tumour - POD : Free ; ‘Aorta & inferior vena cava are seen I | pleural effusion or any lymphadenopathy. IMPRSN : Viable early 7 wks 4 days intrauterine gestation yith ? anterior wall myoma uterus . —— a” Suggested : Review and follow up. With compliments for kind referral ZN 1B-Ss ‘punishable by law. Itis not done inthis case . Disclaimer: Determination of sex. of fetus is an offence in their entire length and appear normal . There is no evidence of ascites , he items tested. Portia Reproduction ofthis Report is not permitted. Specialy for 4D Ultrasound »TMT » HOLTER®| PFTs E(G» EEG= COLOR DOPPLER = DIGITAL X-RAY CHO CARDIOGRAPHY» COMPUTERISED PATHOLOGY = UROFLOWMETRY HB. : USG isa diognsticoid FO] ‘This Results relate only oteae ELA UE L EM CUE Le el) Ee Time Diet Plan Prete te 07.00am Mik ormtney 08.00.m ily (4) /Dosa (2) with Groundnut Chutney/Vadal You pve at abdomna ‘Veg.Upmat1/2 Cup setrgeeyetre 410.00.2m —Banana-1/GroundnutChitkes-2'Sprouts aa ‘Steves kegped win Wihyourtanés on Wh you sheers 12,00 Noon Rice 2 cups with Dhal, -\cup, Green leafy a Saciititd arduous eeeepeae (Setiyetbote fern, Rename yaaa Srledetace stirs Suncen sourancisee (04.00 pm Any fut juics-200miFrut 100 gnvDry Fruits ee Laas 06.00 p.m Rag java with mik/Coconut Water-200m! 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