CONTACT US    
     
Address 11, Opp. Jain Mandir, Main Road, Jahangirabad, Bhopal  
       
Phone No. 0755-2768488 (Before visiting the Clinic Kindly take an appointment on any of the Given Numbers.)  
       
Mobile No. +91-7869138581
+91-9229677742
 
       
Email contact@drhussains.com  
       
Timing Mor - 10:00am to 2:00 pm, Eve - 6:00pm to 9:00pm
Sunday - 11:00am to 2:00pm
 
       
 
FILL YOUR DETAILS FOR CASESHEET
Name
:
S/O, D/O, W/O :
Age : Sex :
Religion : Marital Status :
Occupation : Provisional Diagnosis :
Address : Email :
Contact No.
:
Consultation For :
Comments
:
Main Complaints :
Origin : Duration :
Progress : Modalities :
PAST HISTORY
Any similor trouble before? :
Any other desease in the past? :
* Example : Typhoid, Malaria, Influenza,     Tuberculosis, Dysenter, Jaundice,     Worms, Skin Disease, Infections disease     etc.
Any operation/Surgery :      
PERSONAL HISTORY
Appetite : Thirst :
Desire : Aversion :
Bowels :
* Example: Regular, Constipated, Loose      Stool
Type of stool : * Hard/Small
Urine: Day, Night, Any Burning :
Sweat : * Example: Forehead, Nape, the neck,    Palms, Soles, Whole Body, On Sided
Sleep : * Normal, Disturbe, Heavy
Dream : Temperament :
Mood : Addiction :
Obesity :      
PHYSICAL EXAMINATION
Details :      
LAB INVESTIGATIONS
Blood : Urine :
Stool : Sputum :
X-Rays : USG :
Special :      
         
 

Patients opting for online consultation and getting medicines by courier can either directly deposit the amount to my State Bank Of India account number "10486506371" payable to Dr. S. Tariq Hussain at Jahangirabad branch, Bhopal or you can transfer the money by netbanking facility to my State Bank Of India account number "10486506371" payable to Dr. S. Tariq Hussain at Jahangirabad branch, Bhopal.
















     
 
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