/ (Current ID : 29-4144)

Patient ID :   Demographic Information | Patient ID 29-4144 | AI Report | Result awaited (Suspected TB/Non-TB) ( ) Hospital Name : IGGMC, Nagpur, Nagpur Institute Name : IGGMC, Nagpur, Nagpur Name of Patient Dhanraj Nandeshwar Date of Enrollment 27-05-2024 Age Category Adult Age Gender Male Name of Father/ Mother(in case of child) Contact No Address Nagpur UHID/Hospital Ref ID 4656657 Nikshay Id (if Applicable) Remarks Sign & Symptoms Night Sweats : ? Evening rise of temperature : ? Relieved on taking Antipyretics : ? Cough : ? Loose : ? Vomiting : ? Pain on Passing Urine : ? Sore Throat : ? Shortness of Breath : ? Chest Pain : ? Loss of Weight : ? Loss of appetite : ? Any Blood in Sputum : ? Weakness : ? Enlarged lymph nodes cervical : ? Enlarged lymph nodes axillary : ? Enlarged lymph nodes inguinal region : ? History of smoking : ? Any other Signs or Symptoms : Additional history, in case of child Feeding well : ? Active : ? Weight Loss in last 3 months : ? Failure to gain weight in last 3 months : ? Recurrent Abdominal Pain : ? Seizures : ? Irritability : ? Lethargy : ? Drowsiness : ? Any other, Please Specify : Duration of complaints Any Investigation already done Provisional diagnosis (by Physician) New Investigations Specific investigations: Chest X-ray Date of chest X-ray 01-01-1970 Any other Investigation (USG, CT,MRI etc) Physician/Radiologist Observation/Report Final Diagnosis by Physician Category of x-ray diagnosis Result awaited (Suspected TB/Non-TB) Findings on x-ray Any other remarks Comment by Site Treatment Initiation CRF Filled By CRF Verified by x-ray image upload status | Original X-Ray :

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