CR No.: 211022208833391 OPD CARD (Duplicate) www.scbmch.

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Patient Name: Soumya Ranjan Panda Age/Sex: 22 Yr /Male

S/O: Rabindra Nath Panda Date & Time: 21-December-2022 11:31:31
Department: Orthopaedics Appointment Date: 21-Dec-2022
Vitals: Chief Complaints: Diagnosis/

Diagnosis(Prov):
Ht:..............(Cms)
Past History:
Wt:...........(Kg)
Hyper
Pulse:.........../min
Tension:   (Y/N)
BP:...........mm/Hg
Diabetes:   (Y/N)
Temp:...........*F
COPD:   (Y/N)
RR:.........../min.
Oncology:   (Y/N)
SPO2:...........%
CAD:   (Y/N)
Investigations:
Tuberculosis: (Y/N)
Examination:

CBC/LFT/KFT
Thyroid:   (Y/N)

Blood Sugar(R/F/PP) Surgery:   (Y/N)

HB/TLC/DLC Other:   (Y/N)

ESR/Bood Urea

S.Creatinine/S Uric
Acid

Serum Bilirubin

SGOPT/SGPT

Lipid Profile
Treatment(Rx):
Blood Group

T3,T4,TSH

Urine R/M

X-Ray Chest PA View

USG Abdomen

TMT/Echo,ECG

Others

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