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    Dr. D R Kulkarni operates the Liver and Pancreas Clinic located at Lilavati Hospital & Research Center in Bandra West, Mumbai. The clinic can be contacted for consultations at +91-982-104-6391 or through their website at https://www.liverandpancreasclinic.com. The provided document is a template for collecting a patient's name, age, sex, date, allergies, past medical history, habits, and conducting a functional, fall risk, psychological, and pain assessment.

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    Dr. D R Kulkarni operates the Liver and Pancreas Clinic located at Lilavati Hospital & Research Center in Bandra West, Mumbai. The clinic can be contacted for consultations at +91-982-104-6391 or through their website at https://www.liverandpancreasclinic.com. The provided document is a template for collecting a patient's name, age, sex, date, allergies, past medical history, habits, and conducting a functional, fall risk, psychological, and pain assessment.

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    Prescription

    Uploaded by

    GyanendraSingh
    Dr. D R Kulkarni operates the Liver and Pancreas Clinic located at Lilavati Hospital & Research Center in Bandra West, Mumbai. The clinic can be contacted for consultations at +91-982-104-6391 or through their website at https://www.liverandpancreasclinic.com. The provided document is a template for collecting a patient's name, age, sex, date, allergies, past medical history, habits, and conducting a functional, fall risk, psychological, and pain assessment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Liver and Pancreas Clinic

    Dr. D R Kulkarni

    Lilavati Hospital & Research Center


    Bandra Reclamation, KC Road, Bandra West Mumbai - 400050
    Mumbai, Maharashtra

    For Consultation : +91-982-104-6391


    For Appointments : https://www.liverandpancreasclinic.com

    Name : ................................................................................................ Age : ..................... Sex : .......................... Date : ...............................

    Allergy :

    Past Medical History :

    Diabetes mellitus

    Hypertension

    Asthma / COPD

    Coronary Heart Disease

    Hypothroidism

    Habits :

    Smoking / Alcohol / Others

    Special Assessment
    Functional assessment :
    Fall risk assessment :
    Psychological assessment :
    Path assessment : (Score 1-10)

    Doctor's Signature

    _________________________________________________________________________________________________________

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