C/o swelling in the anal region

H/O Pain (+)

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Tab. Novamentin 625mg (6) 1- 0 – 1

Tab. Fenak Plus (9) 1–1–1

Tab. Cipzen Forte (6) 1–0–1

Tab. Okacet10mg (3) 0–0–1

Tab. Multirich (5) 0–0–1

Tab. Pilex (1) Bottle 2–2–2

‘/Cap. Pantosec DSR (6) 1 – 0 – 1 (BF)

Oint. Smuth (1) tube Ext. Apply Only

Cap. Pantosec DSR (6) 1 – 0 – 1 (BF)

Oint. IG Paint (1) Bottle Ext. Apply Only

 ∆ : Hemorrhoids
C/O Pain over the anal region(+) since 2 days

H/O: Growth seen in the anal region, Bleeding

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℞

Tab. Novamentin 625mg (6) 1- 0 – 1

Tab. Fenak Plus (9) 1–1–1

Tab. Cipzen Forte (6) 1–0–1

Tab. Okacet10mg (3) 0–0–1

Tab. Pilex (1) Bottle 2–2–2

Cap. Pantosec DSR (6) 1 – 0 – 1 (BF)

Oint. Smuth (1) tube Ext. Apply Only

Advice:

Ref.To Chettinad hospital for further management

C/o swelling in the Right ankle joint for past 2 months

- increase in size
- Associated with pain
- No restriction of movts

O/E :

Patient conscious