|
|
| MRD / Regn No. |
: SG004056 |
Date |
: 16/06/2026 |
| Patient Name |
: ASHA MODI |
Age & Gender |
: 61 Yrs. / Female |
| Contact No. |
: 9830180844 |
UHID |
: |
| Ht / Wt / BMI |
: 155 / 74 / 30.80 |
BP S / BP D |
: 156 / 81 |
| Allergies |
: NKA |
Referred By |
: |
| |
|
| Problem
List |
: |
PAST H/O BREAST CANCER: TREATED (19/Dec/2025) | TYPE 2 DIABETES (19/Dec/2025) | HYPERTENSION (19/Dec/2025) | HYPOTHYROIDISM (19/Dec/2025) | |
| Salient Investigations |
: |
CREATININE: 0.7 | EGFR EGLOMERULAR FILTRATION RATE: 91.02 mL/min/1.73m2 | FASTING PLASMA GLUCOSE (FPG): 90 mg/dL | HBA1C GLYCOSYLATED HEMOGLOBIN: 6.8 % |
|
|
S# |
Generic (Trade) Name |
Route |
Dosage |
Usage |
Duration |
|
1 |
TABLET THYROXINE 75 MCG THYRONORM 75 MCG Medicine For HYPOTHYROIDISM |
PO |
1-0-0 |
BEFORE BREAKFAST
|
TILL NEXT VISIT |
| MUST BE TAKEN ON AN EMPTY STOMACH. COFFEE TEA OR BREAKFAST MUST BE TAKEN ONLY AFTER 30 MINUTES. OTHER DRUGS CAN INTERFERE WITH THE ABSORPTION OF THYROXINE | |
|
2 |
ANTIHYPERGLYCEMIC DAPAGLIFLOZIN 10 MG + METFORMIN SR 500 MG APDA M 500 MG |
PO |
1-0-0 |
BEFORE BREAKFAST
|
TILL NEXT VISIT |
|
|
3 |
ANTIHYPERGLYCEMIC LINAGLIPTIN 5 MG APLIP 5 MG |
PO |
0-0-1 |
BEFORE BREAKFAST
|
TILL NEXT VISIT |
|
|
4 |
TABLET ROSUVASTATIN 20 MG STATEZE R 20 |
PO |
0-0-1 |
BEFORE DINNER
|
TILL NEXT VISIT |
|
|
5 |
ALPRAZOLAM 0.5 MG RESTYL |
PO |
0-0-1 |
BEFORE DINNER
|
TILL NEXT VISIT |
|
|
6 |
TELMISARTAN 40 MG + CHLORTHALIDONE 6.25 MG TELMA CT |
PO |
1-0-0 |
BEFORE BREAKFAST
|
TILL NEXT VISIT |
|
|
| |
|
|
|
| Refill :
0 / Substitution: |
|
|
| Education |
: |
| Next Visit |
: 16/Dec/2026 |
| Tests Suggested For Next Visit |
: HBA1C-HPLC METHOD,CREATININE,RETINA CHECK UP,UACR:SPOT SAMPLE |
| |
|
| |
|
 Dr. Samit Ghosal
MD (GM), Diploma in Diabetes Cardiff University, MSc (Diabetes Care) Glamorgan University, Diploma in Endocrinology Glamorgan University (USW), SCOPE certification in obesity management
West Bengal /
54020
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