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Dr.Ulhas Patil Homeopathic Medical College & Hospital,Jalgaon
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Operations Scheduling (OT Patient Information )
Current Year
IPD No
Patient Information
OPD No
OPD Date
IPD Date
Department Name
Patient Name
Age
Gender
Address
City
Taluka
Mobile No
Operation Details
Operation Date
Day
OT No.
Diagnosis
---Select Diagnosis---
Click for New diagnosis Add
Operation
---Select Operation---
Click for New Operation Add
OT Name
---Select Operation Name---
Study Type
GENERAL
CRITICAL
INTERESTING
OT Type
MAJOR(PLANNED)
MAJOR(EMERGENCY)
MINOR(PLANNED)
MINOR(EMERGENCY)
DAYCARE
NA
Deliveries Type
-
NORMAL
CAESARIANS
INSTRUMENTAL
NA
No.Of Male Child
No.Of Female Child
Implant use for Orthopedic operation
If,New Implant Name Add
Implant 1
Implant 2
Implant 3
Operation From Date
In-Time (Hrs) (MM) (AM / PM))
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AM
PM
To Date
Out-Time (Hrs) (MM) (AM / PM))
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AM
PM
Select Surgeon Name
If,New Surgeon Name Add
Add Surgeon Name
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Surgeon Name
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Selected Surgeon Name
SurgeonName
Operation Note :-
Anaesthetist Name
If,New Anaesthetist Name Add
--SELECT--
Anaesthesia Type
S.C.BLOCK
BLOCK
LA
LA + SEDIATION
SGA
GA
SA
RA
NA
Anaesthesia(Major/Minor)
MAJOR
MINOR
Anaesthesia Notes
Diagnostic Procedure
Diagnostic and Therapeutic blocks
ICU/Accident, emergency & resucitation
Investigation Advised
Opinion
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Incharge Name
If,New Incharge Name Add
MAJOR
MINOR
Nursing Staff
If,New Nursing Staff Name Add
MAJOR
MINOR
Histopath Report
YES
NO
OT (Free / Paid)
FREE
PAID
Scheme
--Select--
Total Amount
OT (Postpone /Cancelled )
-
POSTPONE
CANCELLED
Reason
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