Research Institute

SGT Medical College, Hospital &

-(A Constituent of SGT Unfverstty)-
(Haryana)-122505 Ph. :0124-2278183, 2278184, 227818s
Budhera, Gurugram-Badli Road, Gurugram

& RE-ASSESMENT NOTES

DOCTORS PROGRESS

Ward/ Bed No ... Doctor Name . . .

Name of Patient . . '******

CRNo.
DOCTOR'S INSTRUCTION
DATE PROGRESS & RE-ASSESMENT NOTES

Pain iN hip Sioce x 1 h.

Diicult o Lek*6 Montas.

itmout S+ic 2 moNth
pifficot
Difficot in oU in x

HO PreHTIlen
Pt Appet wn 1 n Azo H e developR

Pai Hip Hip

Oset
Peainn qetakoaa intidjovs i
Ihadbul P*herie
AaaschHJ T Toidt moemedt

NO Pediattn

t
Pt Havis Jiicult1 i Wal sie
Gnont, Tsi tHally pt o
impin l e wuli

Utterly Unimaginable
No pain Discomforting Distressing interise horrible unspeakable

Very mild 1olerable Very

distressing Very
intense
Excruciating
unbearable

DCN/SGTMCH/F&F/117
ThN Pt Has t Auke Svpport of sthdk to LOalk sive 2mos

Pt Also USets Rite Bicyele 6 monts Lauk but Now

He Havi dficul t is ne same
Pt go Ho Fll Tre 1 yns Back. Pt to
h e ctioN Fro lolul Hs pi Sum, a n
tal For e
fLy + o t Huv) Coplit Por pad|
dificu to

t tand is
ta elicotion for tpaip osof
since 1 .

No HHo Feue
No Ho wt Loss
NO Ho Loss of Appeth4e

Pt
Pt Cme ts ST Hss pitl oN 12
 Research Institute
SGT Medical College, Hospital &
(A
Conatiuent of sT Untverstty)
Ph. :0124-2278183, 2278184, 2278185
Gurugram-Badi Road, Gurugram (Haryana)-122505
Budhera,

DOCTORS PROGRESS & RE-ASSESMENT NOTES

CR No **** *********'** Name of Patient.. .. Ward/Bed No... DoctorName..oons

PROGRESS & RE-ASSESMENT NOTES DOCTOR'S INSTRUCTION
DATE

Pt Histo
No Ho TS, DM, H pereosio redicatior)
Ho An Sure

ersonal HHst
Ho Tobatco cntwina t i m e CA de

HO aCsiadeuAcoo drindsie 11
ChraieAl Cool drinti LRfore Net
N6 A eeH m n t s 0 Bedden.

Fol H1to
No caniic E Fudla Histo

No pain Discomforting Distressing ntense Unmaginable

hoFmble unspeakabla

10
rymlcd Tolorabla Very Very
distressing ntense ExCnciating
unbearable

DCN/SGTMCH/F&F/117
 ELemn over Bom
L pithin
Fotpejest.

No PeriOrbi) pvinem
P 1443 mmH
do Edos od
s i s of Ti
2 BPM. No Ca3sis
Tep 6 ' f o CDLbir
1on Dan in.
spo
olphudeprA

CUS
NAD

Loced Exmni e H o af Lt HP

INS peation A4 +Htoso'. Hip fMexio,Extere1 Patytia

Alodb chiow
Sep.
Sharti of (LE Lawer Lim
4ip k rlutu) PezioN
St ove
Pp pe4 Nomuu

No Pe ne
NO Swel li
N Frnead Ma of )]:
No Dis(huagina Siy
 SGT Medical College, Hospital & Research Institute
-(A Constituent of SGT University)-
Budhera, Gurugram-Badli Road, Gurugram (Haryana)-122505 Ph. :0124-2278183, 2278184, 2278185

DOCTORS PROGRESS & RE-ASSESMENT NOTES

CR No. Name of Patient . . . .. Ward/ Bed No . . . Doctor Name.

DATE PROGRESS & RE-ASSESMENT NOTES DOCTOR's INSTRUCTION

Palpaction)
M
ipspectoe+inling coimd by e pon
No f on
DPA°TA palpalle
Tendernos pheenE ove Avletior As pet ot

No pain Discomfortng Distressing lntensa Utery

horrible
Unimaginable
unspeakable

10

Very mid Toleabla very

distressing Vey UDh ung
nt unoearaoie

DCN/SGTMCH/F&F/117
Semso &rana Dectiond

C
C3

T
T

Te
T
T1o

T 12

L
S
S2
 SGT Medical College, Hospital & Research Institute
-(A Constituent of SGT Untversity)-
Gurugram (Haryana)- 122505 Ph.: 0124-2278183, 2278184, 2278185
Budhera, Gurugram-Badli Road,

DOCTORS PROGRESS& RE-ASSESMENT NOTES

Name of Patient. ... Ward/ Bed No... Doctor Name.

CR No ..
DOCTOR'S INSTRUCTION
DATE PROGRESs & RE-ASSESMENT NOTES

Motor ExmnH w

Toroe ofMVsclez o Botn leas o u r Unss

iNCHeud

Clep e f e 2iziita s
-

A ple doNUy .
Paoer
Flexd r s
Hip

/lxor

ANleDors) Flexiov

ToeDohsi HlRxîOVw.

Intense
Utteny Unimaginable
No pain Discomforting Distressing hormble utspeakabla

10

Tolerable dieery Very Excuciaung

unbearable
Very mild distressing intense

DCN/SGTMCH/F&F/117
Deep Teradod PeF1ex

raae Terk

Antle Tr

Biceps Jerk

Trices Ten
SvpetHual lef1ex

Pluntr PeFex BabivsKi pstine, BoM s)

Abdoi0
 SGT Medical College, Hospital & Research Institute
-(A Constituent of SGT Untversity)-
Ph. :0124-2278183,2278184,2278185
Budhera, Gurugram-Badli Road, Gurugram (Haryana)-122505

DOCTORS PROGRESS & RE-ASSESMENT NOTES

Name of Patient . . Ward/ Bed No ... . Doctor Name ...

CR No...
PROGRESS & RE-ASSESMENT NOTES DOCTOR's INSTRUCTION
DATE

Provisiodd Asi 99 AvN Hip

A
PBH -

AP.
X-P
MP Dorsd spive hole Spine Scrta)

Covid-13 TPCe2

T.2eradl -P Plo BD
T.Patop ye Plo D
T. Nnoi od For 4e 1
Dr. KULDEEP PINDARIA T)
D.
CPr TE
Resident Docdor
Deptt. of OrthopaedicsS

Gurgaon (HR)
Hospital,
SGT

No paln Discomforting Dlstressing Intenae Utteny

honble
Unamaginabke
unspeakable

Very mild Tolerable ery Expcng

distreasiNG internse unbearatble

DCN/SGTMCH/F&F/117