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 in the relevant information or tick, as appropriate.)

Doctor’s Details

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

Name *

@else

Name *

@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 *

H/O Atopic dermatitis/asthma *

Yes No

Family history of Atopic dermatitis/asthma *

Yes No

Food habit *

Vegetarian Non-vegetarian

General Examination Findings

Pulse(minute)

Blood Pressure: Systolic(mmHg)

Diastolic(mmHg)

Weight(in Kg)

Height(in cm)

Body Mass Index (BMI)(kg/m²)

Details of the disease

Investigations done

CBC

Date of report

CRP

Date of report

IgE

Date of report

IgG anti-TPO

Date of report

If any other, please specify with date of report

Any Other

Date of report

Drugs being used in management of Urticaria

Drug	Dose/Strength (in mg unless specified)	Frequency of dosing
Levocetirizine	5 10	OD BID
Desloratadine	5 10	OD BID
Bilastine	20 40	OD BID
Fexofenadine	120 180	OD BID
Any Other	5 10	OD BID