CityCare
Hospital
CityCare Hospital
Prescription — Rx
Date: 22-09-2026 10:05
Dr. S. Mehta
MBBS, MD (Medicine)
Address: CityCare Hospital, 14 Ring Road, New Delhi 110024
Phone: +91-11-4567-8900
Emergency: +91-98100-11223
NMC Reg: DMC-48215
Patient: Ramesh Gupta
54Y / M
Address: C-88, Amar Colony, New Delhi
UHID: UHID-2024-118822
Weight: 72 kg
Allergy: NKDA
Symptoms / Chief Complaints
Symptoms: Polyuria (increased urination), polydipsia (increased thirst), mild blurred vision
Vitals
BP: 138/86
Pulse: 84
SpO2: 98%
Temp: 98.6°F
Examination
Baseline examination deferred; full eye review advised.
Diagnosis: Type 2 Diabetes Mellitus with hypertension
Investigations: HbA1c, Fasting lipid profile
℞
| Sl. | Generic (CAPS) + strength | Dose | Freq | Duration |
|---|---|---|---|---|
| 1 | METFORMIN500 mg · After food · OralRx — H | 1 tab | 1 - 0 - 1(Morning - Lunch - Dinner) | x 30 days |
| 2 | AMLODIPINE5 mg · After food · OralRx — H | 1 tab | 1 - 0 - 0(Morning - Lunch - Dinner) | x 30 days |
| 3 | AZITHROMYCIN500 mg · After food · OralRx — H1 | 1 tab | 0 - 1 - 0(Morning - Lunch - Dinner) | x 5 days |
| 4 | ALPRAZOLAM0.25 mg · Before food · OralRx — X | 1 tab | 0 - 0 - 1(Morning - Lunch - Dinner) | x 7 days |
- • Schedule H drug — to be sold by retail only on the prescription of a Registered Medical Practitioner.
- • Schedule H1 drug — to be sold by retail only on the prescription of a Registered Medical Practitioner; entry in the Schedule H1 register mandatory.
- • Schedule X drug — second (duplicate) copy of this prescription is retained by the prescriber.
Prescription valid for 15 days from the date of issue. Review on 22-10-2026 or earlier if symptoms worsen.
Dr. S. Mehta
MBBS, MD (Medicine) · Reg: DMC-48215
Signature + seal