Digicon

@if (isset(session()->get('doctor')['vCentralCode'])) {{ session()->get('doctor')['vCentralCode'] }} @endif

@if (isset(session()->get('doctor')['vCentralCode']))

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@endif

@csrf

@if (isset(session()->get('doctor')['vCentralCode']))

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@else

@endif

Patient {{ $iPatientNo }}

(Kindly fill the relevant information or tick, as appropriate.)

Doctor’s Details

@if (isset(session()->get('doctor')['vCentralCode']))

Name of Doctor*

@else

Name of Doctor *

@endif

Registration No. *

Qualification *

@if (isset(session()->get('doctor')['vCentralCode']))

Speciality *

@else

Speciality *

@endif @if (isset(session()->get('doctor')['vCentralCode']))

Hospital/Clinic Address *

@else

Hospital/Clinic Address *

@endif @if (isset(session()->get('doctor')['vCentralCode']))

City *

@else

City *

@endif @if (isset(session()->get('doctor')['vCentralCode']))

State *

@else

State *

@endif

Patient’s Details

Initials *

OPD/IPD Registration No

Gender *

Male Female

Age (in Years) *

City/Town *

State *

General Examination Findings

Pulse (per minute)

Weight (in kg)

Height (in cm)

Diagnosis *

Fungal Infection

Any other

Investigations done to diagnose fungal infection *

KOH mount

Yes No

Is the Fungal infection in patient

Naïve Recurrent/Recalcitrant

If patient is having recurrent fungal infection, then H/O of treatment taken

Treatment given*	Dose with frequency*	Duration*

History of any comorbidities in patient *

Diabetes mellitus

Yes No

Hypertension

Yes No

Obesity

Yes No

Treatment given*
Systemic antifungal
Topical antifungal
Any other If any other, please specify

Dosage*
Systemic Antifungal given	Frequency of Dosage	Duration in weeks/Any Topical Added
Alcros SB 130MG	OD BID
Any other If any other, please specify	OD BID