*US2000000128009* *S20O23100007020*

Name: Mrs. Shayesta Nigar Mohammad Yousuf Jamali MR No: US2000000128009

Age/Sex: 39y ( 16-07-1984 ) / Female Visit ID: S20O23100007020
Doctor: Dr. Betty John Visit Date: 04-10-2023 10:52
Department: Gynaecology & Obstetrics Phone No: 0507740147
Sponsor: NAS ADMINISTRATIVE SERVICES LIMITED Member ID: I017-004-113456567-01
Pri Ins Net/Plan Type: NAS-ADNIC-RN(T2) Pri Plan Name: NMCRH-SHJ NAS-ADNIC-RN(T2) (Cons
20%Max 50, Ph 10%)

Prescription Note

Weight: 96.95 Kg

Allergies Details

Allergy Type Allergy Description Date of Onset Reaction Status Severity

Other No Allergy Active None

Obstetric Details

Estimated Due Date EDD By LMP EDD By Scan

NA

Principal Diagnosis: N92.1 - Excessive and frequent menstruation with irregular cycle
Secondary Diagnosis: E03.9, N86, M06.9, N80.0, D50.0, N94.5,

Dosage/Frequency/Route/Admin Refill
No Medicine Name/Strength/Form Duration Qty Instructions
Strength Count
Use 1 Tablet Once
Dienogest 2 Mg Film Coated Tablets / 2MG / Film 1 Tablet / ONCE DAILY / Oral/1 Daily For A
1 1M 30 0
Coated Tablets Fr:04-10-2023 To:03-11-2023 Duration Of 1
Months./

Doctor Name: Dr. Betty John Registration Number: MOHD20086 Doctor's Signature

Prepared By: Date: ID No.:

Prescription Reviewed Patient Counseled Dispensed By:

P.O.Box:6222, Abu Dhabi, UAE e-mail:hospitalauh@nmc.ae website:www.nmchealthcare.ae Signature of Patient/Next of kin Name
Tel: +971-2-6332255, Fax: +971-2-6317303