Home     l  Contact us    l   Therapy Center   l   Press Coverage     l    Disclamer   l    Copyright

 


Cell. No. 0 9910034500

email
drharishverma@gmail.com


Medinet Healthcare Center
SCO 34, 1st Floor, Sector 31 – D,
Chandigarh, India

Consult Dr.Verma

You can consult Dr. Harish Verma
By sending e-mail: drharishverma@gmail.com
By phone: 0091-11-22050506, By Fax: 0091-11-22050504
Consultation on Telephone is free of cost but you should send an e-mail to seek appointment with Dr. Harish Verma for consultation over telephone.
 

 
Please fill out following
 
 
               Name
               Age 
               Sex
               Address  
               City  
               State  
               Zip/Postal Code  
               Country 
               Telephone  
               Fax  
               E-mail  
Present complaints  

Please mention all the main complaints with their duration. In case certain complaints, which are not permanent but occur occasionally, you should also mention details of those complaints. Also specify if there is any relation of your complaint with food, life style, rest, exercise, season, medication, work place, occupation etc. :

  History of past illness  
Mention the details of details previous illnesses you have suffered in the past (e.g. viral infections, injuries, systemic diseases etc.) along with the age of onset, duration and outcome. :
 Family history: 
Has your near relatives had such complaint
 History Related to Hepatitis 
When your diagnosis of Hepatitis was made?  
Are you suffering from Jaundice (Yellow discoloration of eyes, urine or skin)
Are you suffering from Ascites (Free fluid in abdomen)
 
Are you suffering from Low-grade fever
Are you suffering from Nause or vomiting
Are you suffering from Blood in vomiting (Hematemesis)
 
Are you suffering from Headaches/ Bodyaches
 
Is HbsAg Test Positive in your blood?
 
Is HCV RNA Test Positive in your blood?
What is your viral Load?
 
What is your Platelet count?
 
What is your ALT (SGPT) level?
 
What is your Total Billirubin level?
 
What is your Ultrasound/MRI/CT Scan Report?
 
What is your Liver Biopsy Report?
 
Please type the characters you see in the above picture.
     
 

©Medinet Healthcare Center, SCO 34, Ist Floor, Sector 31 - D, Chandigarh - India