Communication

CHOOSE MODE OF COMMUNUCATION

Email Video conference

RECOMMENDED REPORTS

(file format only PDF ,jpeg,& word file)
(file format only PDF ,jpeg,& word file)
(file format only PDF ,jpeg,& word file)

SEX

Male Female

Social History of Patient

1. Do you smoke? If so how many per day
Yes No
2. If an ex-smoker, when did you give it up?
Yes No
3. Average weekly alcohol consumption: state quantity ?
Yes No
4. Have you ever had a suregry or medical emergency before?
Yes No

I Dr. Enter Doctor Name Here certify that the above mentioned diagnosis is as per my physical examination of the patient and other diagnostic tests prformed on the patient.The Patient has been referred to in India for further treatment and surgical intervention if needed.

Diagnostic Reports as Attachments

(file format only PDF ,jpeg,& word file)
(file format only PDF ,jpeg,& word file)
(file format only PDF ,jpeg,& word file)

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