Secondary Test

 

  Personal Details
       
  Name * :
  Age * :
  Sex :
  Hospital Number :
  Address * :
  City * :
  P.O. Box * :
  Country * :
  Telephone * :
  Mobile * :
  Abroad Number :
  Email * :
  Weight (kg) * :
  Height (cm) * :
  Waist Circumference (cm) * :
Medical History
 
       
Diabetes Hypertension
Coronary Artery Disease Respiratory Disease
Exertional Dyspnoea Sleep Apnoea
Knee Joint Disease Dyslipedemia
Depression Migraine
Hirsutism PCOD/infertility/Mens. irregularities
Cancers Others
Family H/o DM, HTN, CAD Smoking/alcoholism
Preffered Food Items & Quantity
  Tests
 
 
Blood RoutineĀ  Urine Routine
Blood Urea Random Blood Sugar
Serum Creatinine Serum Electrolite
HIV, HBsAG Thyroid function
Blood Group Liver Function Test
PT with INR Fasting Lipid Profile
HbA1C Serum Fasting Cortisol
BT,CT