Submit Patient's Reports

Patient Reports form
Kindly fill the Patient's Reports and also upload the patient files as suggested by Your Doctor
Name of the Patient * :
Diagnosis * :
Date of Transplant Surgery * :
Medications
Myfortic (in mg) :
CLBS NO. :
Contact Number * :
E-mail address :
Medications
Tab.Prograf (mg) :
Wysolone (in mg) :
Tab.Cellcept (in mg) :
Investigations
Hemoglobin :
TLC :
Platelet :
Alpha-Fetoprotein :
INR :
Bilirubin * :
SGOT/ AST :
SGPT/ ALT :
Albumin :
Urea :
Creatinine * :
HBA1C :
Na/K :
Tac level :
Co Level :
Sirolimus Level :
Any other Problem :
Upload patient Reports * :
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