DigiCon

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

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

Name *

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Name *

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Presenting complaint
Date of LMP
Menstrual cycles	Regular Irregular
Duration of menstruation period (Days)
Cycle length	<23 days 23-39 days >39 days
Dysmenorrhea	Present Absent
Menorrhagia	Present Absent

TRAPIC MF tablet for oral administration Dose used:
No. of Tablets /dose:	1 2
Dosing frequency:	OD BID TID
No of days of Trapic MF per cycle (Days):
Duration since initiation of TRAPIC MF therapy:	Days weeks Months
Indication for use:

Reasons for choosing TRAPIC MF tablet *

(Kindly tick all the potential reasons Options are multiple selection)

Non-hormonal option

Lesser treatment duration

Patient compliance

Effectiveness