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  • Christopher Discar (Qkentz) - Illness and Injury Report

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    Victoria Gomez
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    1. Christopher Discar, a 46-year-old Filipino civil supervisor, reported to the GV Camp Clinic with mid-epigastic pain. 2. The doctor diagnosed Discar with a history of ulcers and prescribed medications including omeprazole, domperidone, and aluminum magnesium suspension. 3. Discar was referred to an offsite medical center for further management and treatment.

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    Christopher Discar(Qkentz)-Illness and Injury Report

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    1. Christopher Discar, a 46-year-old Filipino civil supervisor, reported to the GV Camp Clinic with mid-epigastic pain. 2. The doctor diagnosed Discar with a history of ulcers and prescribed medications including omeprazole, domperidone, and aluminum magnesium suspension. 3. Discar was referred to an offsite medical center for further management and treatment.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as XLS, PDF, TXT or read online from Scribd
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    Download as xls, pdf, or txt
    21 views1 page

    Christopher Discar (Qkentz) - Illness and Injury Report

    Uploaded by

    Victoria Gomez
    1. Christopher Discar, a 46-year-old Filipino civil supervisor, reported to the GV Camp Clinic with mid-epigastic pain. 2. The doctor diagnosed Discar with a history of ulcers and prescribed medications including omeprazole, domperidone, and aluminum magnesium suspension. 3. Discar was referred to an offsite medical center for further management and treatment.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xls, pdf, or txt
    of 1

    ILLNESS AND INJURY REPORT

    Patient Information Name: Christopher Discar Age: 46 Nationality: Filipino Area of Assignment: Position: CIVIL SUPERVISOR Section A. To be filled by the Doctor: Company: QKENTZ BADGE NO: JBOG-13217

    JBOG Recovery Project

    Incident 00/06/2012 Time of Incident: 0000 HOURS Reported to GV Camp Clinic: 25/08/2012 at 12:00 Hrs. ROOM NO: C4/7 FF1 MOBILE NUMBER: 55472827

    CHIEF COMPLAINT:MID-EPIGASTRIC PAIN Sick Leave: (Pls. tick) > VS: BP: 124/70 PR: 85 T: 36.2 > has hx of ulcer Yes If yes, no. of days: No

    17:40> Sent to RLMC/ALMADINA for further management >QRC/FLUOR NURSE/CAMP MANAGEMENT informed 19:55 Cameback to GV MAC 1. Omeprazole 20mg 1 cap OD 2. Domperidone 1 tab TID 3. Aluminum magnesium suspension 5ml TID >QRC/ FLUOR NURSE/ CAMP MANAGEMENT INFORMED

    ristan Palacpac

    Classification: (Pls. tick) Work-related Injury Work-related Illness Non-work-related Illness/Injury

    Referral: (Pls. tick) Yes If yes, referred to: __________________

    Attended by: DANTE V. AUSTERO - GV MAC NURSE JBOG Recovery Project

    RLIC/Al Madinah Medical Center Al-Khor Hospital Hamad Medical Center

    Note: Please attach all relevant documentation including sick leave forms issued by RLIC, Al-Khor Hospital, etc. before forwarding to HSE for classification.

    Section B. To be filled by Health Safety and Environment (HSE) Manager

    Classification: (Pls. tick) First Aid Medical Treatment Restricted Work LTA

    If LTA, how many days?

    If Restricted Work, state details:

    Comments / Justification of Classification:

    Classified by:

    Section C. Return To Work (RTW) Certification - To be filled by JBOG Recovery Project Doctor Comments: (Please provide details) Fit to return to work Unfit to return to work Reassignment

    Important: Please fax signed copy to Qatargas Medical Center at 4473-6189.

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