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Submit Patient's Reports

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Submit Patient's Reports

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:
(Allowed file type jpg/png/word/pdf)