﻿<!DOCTYPE EPCB SYSTEM "E:\KPinto\SourceCode\GIT\eClaims\ElectronicClaim.vb6\EpcbXmlDtd_v20.dtd"><EPCB pUsername=":ECLAIMS-04-01-2018-00002" pPassword="" pHciAccreNo="H01000908" pEnlistTotalCnt="1" pProfileTotalCnt="1" pSoapTotalCnt="1" pEmrId="" pCertificationId="ECLAIMS-04-01-2018-00002" pHciTransmittalNumber="20220556422"><ENLISTMENTS><ENLISTMENT pEClaimId="2205724568" pEClaimsTransmittalId="50127220556422" pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pEffYear="2022" pEnlistStat="1" pEnlistDate="2022-04-13" pPackageType="A" pMemPin="" pMemFname="" pMemMname="" pMemLname="" pMemExtname="" pMemDob="" pMemCat="" pMemNcat="" pPatientPin="052507239021" pPatientFname="RENZ" pPatientMname="MACEDONIO" pPatientLname="MAPILI" pPatientExtname="" pPatientType="MM" pPatientSex="M" pPatientContactno="NA" pPatientDob="2000-07-11" pPatientAddbrgy="" pPatientAddmun="" pPatientAddprov="" pPatientAddreg="" pPatientAddzipcode="" pCivilStatus="U" pWithConsent="X" pWithLoa="X" pWithDisability="X" pDependentType="X" pTransDate="2022-05-05" pCreatedBy="00978" pReportStatus="U" pDeficiencyRemarks="" pAvailFreeService="X"/></ENLISTMENTS><PROFILING><PROFILE pHciTransNo="C5012720220500103" pHciCaseNo="C5012720220500103" pPatientPin="052507239021" pPatientType="" pMemPin="" pProfDate="2022-04-13" pRemarks="" pEffYear="2022" pProfileATC="CF4" pReportStatus="U" pDeficiencyRemarks=""><OINFO pPatientPob="" pPatientAge="" pPatientOccupation="" pPatientEducation="" pPatientReligion="" pPatientMotherMnln="" pPatientMotherMnmi="" pPatientMotherFn="" pPatientMotherExtn="" pPatientMotherBday="" pPatientFatherLn="" pPatientFatherMi="" pPatientFatherFn="" pPatientFatherExtn="" pPatientFatherBday="" pReportStatus="U" pDeficiencyRemarks=""/><MEDHIST pMdiseaseCode="" pReportStatus="U" pDeficiencyRemarks=""/><MHSPECIFIC pMdiseaseCode="" pSpecificDesc="NO KNOWN COMORBIDITIES 
NO HISTORY OF SURGERIES/TRAUMA
NO KNOWN ALLERGIES TO FOOD OR DRUGS
NO KNOWN INTAKE OF ILLICIT DRUGS
THE PATIENT IS A NONSMOKER BUT IS A HEAVY ALCOHOLIC BEVERAGE DRINKER FOR A YEAR NOW CONSUMING 1-2 BOTTLES OF 2X2 GIN DAILY. STOPPED DRINKING ABOUT 2 WEEKS AGO BUT RESUMED DRINKING AGAIN THE NIGHT BEFORE ADMISSION.
THE PATIENT IS FULLY VACCINATED WITH SECOND DOSE RECEIVED LAST NOV 2021. NO BOOSTER DOSE RECEIVED YET.
THE PATIENT WORKED AS A CONSTRUCTION WORKER WITH HIS FATHER STARTING IN FEBRUARY 2022. 
HE WAS FULLY VACCINATED AS A CHILD COMPLETED AS PER EPI.
HE TB EXPOSURE A S A CHILD (FATHER WAS DIAGNOSED AND TREATED WITH PTB, SIBLING WAS TREATED WITH PRIMARY COMPLEX).
HE IS CLAIMED TO BE IN A MONOGAMOUS RELATIONSHIP WITH HIS CURRENT GIRLFRIEND." pReportStatus="U" pDeficiencyRemarks=""/><SURGHIST pSurgDesc="" pSurgDate="" pReportStatus="U" pDeficiencyRemarks=""/><FAMHIST pMdiseaseCode="" pReportStatus="U" pDeficiencyRemarks=""/><FHSPECIFIC pMdiseaseCode="" pSpecificDesc="" pReportStatus="U" pDeficiencyRemarks=""/><SOCHIST pIsSmoker="" pNoCigpk="" pIsAdrinker="" pNoBottles="" pIllDrugUser="" pReportStatus="U" pDeficiencyRemarks=""/><IMMUNIZATION pChildImmcode="" pYoungwImmcode="" pPregwImmcode="" pElderlyImmcode="" pOtherImm="" pReportStatus="U" pDeficiencyRemarks=""/><MENSHIST pMenarchePeriod="" pLastMensPeriod="" pPeriodDuration="" pMensInterval="" pPadsPerDay="" pOnsetSexIc="" pBirthCtrlMethod="" pIsMenopause="" pMenopauseAge="" pIsApplicable="N" pReportStatus="U" pDeficiencyRemarks=""/><PREGHIST pPregCnt="0" pDeliveryCnt="0" pDeliveryTyp="" pFullTermCnt="0" pPrematureCnt="0" pAbortionCnt="0" pLivChildrenCnt="0" pWPregIndhyp="" pWFamPlan="" pReportStatus="U" pDeficiencyRemarks=""/><PEPERT pSystolic="100" pDiastolic="70" pHr="93" pRr="19" pTemp="36.4" pHeight="160" pWeight="62" pVision="" pLength="" pHeadCirc="" pReportStatus="U" pDeficiencyRemarks=""/><BLOODTYPE pBloodType="" pBloodRh="" pReportStatus="U" pDeficiencyRemarks=""/><PEGENSURVEY pGenSurveyId="2" pGenSurveyRem="ASLEEP BUT AWAKENS TO NAME-CALLING AND TAPPING, EA" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="" pAbdomenId="7" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="99" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="99" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="1" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="99" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="99" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="99" pHeentId="" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PESPECIFIC pSkinRem="(+) NOTED ABRASIONS ON THE LEFT LOWER EXTREMITY FROM PREVIOUS CARRYING, NO ACTIVE BLEEDING, NO EDEMA, FULL PULSES, BRISK CAPILLARY REFILL" pHeentRem="ANICTERIC SCLERAE, PINKISH PALPEBRAL CONJUNCTIVA, NO NASO-AURAL DISCHARGE, NOTED FALSE UPPER FRONT TEETH, NO NOTED TOOTH DECAY/CARIES, NO EAR DISCHARGE AT AURICLE, NO AURICULAR TENDERNESS, NO NECK VEIN ENGORGEMENT" pChestRem="SYMMTERICAL CHEST EXPNASION, CLEAR BREATH SOUNDS, NO WHEEZES" pHeartRem="NO HEAVES, THRILLS, LIFTS, PMI AT 5TH ICS LMCL, TACHYCARDIC WITH REG RHYTHM, NO MURMURS" pAbdomenRem="" pNeuroRem="ASLEEP AND AWAKENS TO NAME-CALLING BUT EASILY DRIFTS BACK TO SLEEP, NO VERBAL OUTPUT AND DOES NOT FOLLOW COMMANDS
CN
II, III - 3/3 MM BRTL
III, IV, VI - INTACT EOMS VIA VISUAL TRACKING
V - INTACT CORNEALS
VII - NO FACIAL ASYMMETRY
VIII - CANNOT BE FULLY ASSESSED
IX, X - ABLE TO SWALLOW
XI - ABLE TO MOVE HEAD SIDE TO SIDE AND RAISE SHOULDERS
5/5 ON ALL EXTREMITIES
WITHDRAWS EQUALLY FROM PAIN STIMULUS
(+) BABINSKI RIGHT
(-) NUCHAL RIGIDITY, (-) BRIDZINSKI, CANNOT ASSESS YET KERNIG'S AS PATIENT IS NOT FULLY COOPERATIVE
NO INTENTIONAL TREMORS OBSERVED, NO NYSTAGMUS
MOTOR- 5/5 ALL EXTREMITIES
SENSORY- INTACT
CEREBELLAR- NO NYSTAGMUS" pRectalRem="" pGuRem="" pReportStatus="U" pDeficiencyRemarks=""/><DIAGNOSTIC pDiagnosticId="0" pOthRemarks="" pReportStatus="U" pDeficiencyRemarks=""/><MANAGEMENT pManagementId="0" pOthRemarks="" pReportStatus="U" pDeficiencyRemarks=""/><ADVICE pRemarks="NA" pReportStatus="U" pDeficiencyRemarks=""/><NCDQANS pQid1_Yn="" pQid2_Yn="" pQid3_Yn="" pQid4_Yn="" pQid5_Ynx="" pQid6_Yn="" pQid7_Yn="" pQid8_Yn="" pQid9_Yn="" pQid10_Yn="" pQid11_Yn="" pQid12_Yn="" pQid13_Yn="" pQid14_Yn="" pQid15_Yn="" pQid16_Yn="" pQid17_Abcde="" pQid18_Yn="" pQid19_Yn="" pQid19_Fbsmg="" pQid19_Fbsmmol="" pQid19_Fbsdate="" pQid20_Yn="" pQid20_Choleval="" pQid20_Choledate="" pQid21_Yn="" pQid21_Ketonval="" pQid21_Ketondate="" pQid22_Yn="" pQid22_Proteinval="" pQid22_Proteindate="" pQid23_Yn="" pQid24_Yn="" pReportStatus="U" pDeficiencyRemarks=""/></PROFILE></PROFILING><SOAPS><SOAP pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pPatientPin="052507239021" pPatientType="MM" pMemPin="" pSoapDate="2022-04-13" pEffYear="2022" pSoapATC="CF4" pReportStatus="U" pDeficiencyRemarks=""><SUBJECTIVE pChiefComplaint="SEIZURES" pIllnessHistory="21 YEAR OLD MALE, 1 WEEK PTA, HE BEGAN COMPLAINING  OF HEADACHE , DIZZINESS, GENERALIZED WEAKNESS, AND FEVERISH FEELING, 5 HOURS PTA, HE WAS NOTED TO HAVE SEIZURES CHARACTERIZED AS GENRALIZED CLONIC TONIC. HE WAS BROUGHT TO ROSARIO DISTRICT HOSPITAL WHERE ANOTHER EPISODE OF SEIZURES WERE SEEN, HE NWAS GIVEN DIAZEPAM IV THEN HE WAS EVENTUALLY TRANSFERRD TO LORMA MEDICAL CENTER HE WAS NOTED TO BE UNCOMMUNICATED AFTER THE FIRST SEIZURE..AT THE ER , HE WAS AGAIN NOTED TO HAVE SEIZURES." pOtherComplaint="" pSignsSymptoms="1;18;22;26;33;32" pPainSite="" pReportStatus="U" pDeficiencyRemarks=""/><PEPERT pSystolic="" pDiastolic="" pHr="" pRr="" pTemp="" pHeight="" pWeight="" pVision="" pLength="" pHeadCirc="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PESPECIFIC pSkinRem="" pHeentRem="" pChestRem="" pHeartRem="" pAbdomenRem="" pNeuroRem="" pRectalRem="" pGuRem="" pReportStatus="U" pDeficiencyRemarks=""/><ICDS pIcdCode="000" pReportStatus="U" pDeficiencyRemarks=""/><DIAGNOSTIC pDiagnosticId="0" pOthRemarks="" pReportStatus="U" pDeficiencyRemarks=""/><MANAGEMENT pManagementId="0" pOthRemarks="" pReportStatus="U" pDeficiencyRemarks=""/><ADVICE pRemarks="NA" pReportStatus="U" pDeficiencyRemarks=""/></SOAP></SOAPS><COURSEWARDS><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-13" pDoctorsAction="21 YEAR OLD MALE, 1 WEEK PTA, HE BEGAN COMPLAINING  OF HEADACHE , DIZZINESS, GENERALIZED WEAKNESS, AND FEVERISH FEELING, 5 HOURS PTA, HE WAS NOTED TO HAVE SEIZURES CHARACTERIZED AS GENRALIZED CLONIC TONIC. HE WAS BROUGHT TO ROSARIO DISTRICT HOSPITAL WHERE ANOTHER EPISODE OF SEIZURES WERE SEEN, HE NWAS GIVEN DIAZEPAM IV THEN HE WAS EVENTUALLY TRANSFERRD TO LORMA MEDICAL CENTER HE WAS NOTED TO BE UNCOMMUNICATED AFTER THE FIRST SEIZURE..AT THE ER , HE WAS AGAIN NOTED TO HAVE SEIZUR
RECEIVED AT ER: WITH POST-ICTAL DROWSINESS, AWAKENS TO TAPPING AND NAME-CALLING BUT DRIFTS BACK TO SLEEP, NO VERBAL OUTPUT AND DOES NOT FOLLOW COMMANDS, WITHDRAWS FROM PAIN BUT WITH PURPOSEFUL MOVEMENTS OF EXTREMITIES ANICTERIC SCLERAE, PINKISH PALPEBRAL CONJUNCTIVA, NO NECK VEIN ENGORGEMENT SYMMETRICH CHEST EXPANSION, CLEAR BREATH SOUNDS NO HEAVES, THRILLS, LIFTS, PMI AT 5TH ICS LMCL, TACHYCARDIC WITH REG RHYTHM, NO MURMURS APPRECIATED SOFT FLAT ABDOMEN, NONTENDER AND WITH NORMOACTIVE BOWEL SOUNDS NO PEDAL EDEMA ASLEEP AND AWAKENS TO NAME-CALLING BUT EASILY DRIFTS BACK TO SLEEP, NO VERBAL OUTPUT AND DOES NOT FOLLOW COMMANDS CN II, III - 3/3 MM BRTL III, IV, VI - INTACT EOMS VIA VISUAL TRACKING V - INTACT CORNEALS VII - NO FACIAL ASYMMETRY VIII - CANNOT BE FULLY ASSESSED IX, X - ABLE TO SWALLOW XI - ABLE TO MOVE HEAD SIDE TO SIDE AND RAISE SHOULDERS 5/5 ON ALL EXTREMITIES WITHDRAWS EQUALLY FROM PAIN STIMULUS (+) BABINSKI RIGHT (-) NUCHAL RIGIDITY, (-) BRIDZINSKI, CANNOT ASSESS YET KERNIG'S AS PATIENT IS NOT FULLY COOPERATIVE NO INTENTIONAL TREMORS OBSERVED, NO NYSTAGMUS CBC: LEUKOCYTOSIS AT 20 WITH SEGMENTER PREDOM OF 0.93; HGB 177 AND HCT 0.52, PLT 262 NORMAL ELECTROLYTES CREA 97 (EGFR 98) PLAIN CT SCAN OF THE HEAD: NO ACUTE INFARCT, ACUTE INTRACRANIAL HEMORRHAGE OR EVIDENT MASS. SMALL MUCUS RETENTION CYST VERSUS POLYP IN THE RIGHT MAXILLARY SINUS. PWI: CNS INFECTION T/C BACTERIAL MENINGITIS VS TB MENINGITIS R/O ALCOHOL WITHDRAWAL SYNDROME, DELIRIUM TREMENS
BP 100/70, TEMP 36.4, RR18, HR 88" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-14" pDoctorsAction="STILL  DROWSY, (?) NECK RIGIDITY WBC 20,000
NO SEIZURES TODAY
COLLECTED CLEAR COLORLESS CSF , OPENING PRESSURE 110 MM H2O , CLOSING PRESSURE 100 MM H2O" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-15" pDoctorsAction="CSF - CSF SUGAR  4.25, RBS 6.8
CSF CELLS 3  , 2 POLYS, 1 LYMPHO,
RBC NINE
INDIA INK - NEGATIVE
CALAS TEST NEGATIVE
BP 120/70 TEMP 37.4 RR 18 HR74 O2 SAT 98% STILL INCOHERENT, DISORIENTED" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-16" pDoctorsAction="BP 120/90	TEMP 37.5	RR 20	HR RR 80
O2 SAT  98 %, SOMETIMES INCOHERENT , DISORIENTED, SUPPLE NECK" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-17" pDoctorsAction="IM WARD RIC NOTES
HOSPITAL DAY 4

UNEVENTFUL DURING THE PREVIOUS DAY
NO SEIZURE EPISODES
AWAKE LETHARGIC, RESPONDS TO LIGHT TOUCH, AND SOFT VOICE, NICRD
BP 130/100
HR 74
RR 20 O2SAT 97
TEMP 36.5
SCWE CBS
AP NRRR NO MURMURS
GCS 15, AWAKE LETHARGIC, ORIENTED TO PERSON, TIME, UNABLE TO IDENTIFY PLACE,
SPEAKS IN SENTENCES, WITH SLOW SPEECH
MOTOR - 5/5
SENSORY 100%
(-) NUCHAL RIGIDITY,
1SR DAY AFEBRILE

ACUTE BACTERIAL MENINGITIS" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-18" pDoctorsAction="BP 110/70 	TEMP 36.6 	RR 18 	HR 60 	OW2 SAT 97%, 2ND DAY AFEBRILE,
SLOW SPEECH, ORIENTED TO PLACE, PERSON, TIME, NO INCOHERENCE" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-19" pDoctorsAction="BP 120/80 	TEMP 36.2 	RR 19 	HR 82 	O2 SAT 95%
STILL WITH MILD DISORIENTATION, SOME HALLUCINATIONS, SOMETIMES INCOHERENT.
THERE MUST BE SOME DEGREE OF ALCOHOL WITHDRAWAL WHICH CAN LAST FOR 2 WEEKS" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-20" pDoctorsAction="IM WARD RIC NOTES
HOSPITAL DAY 7

UNEVENTFUL DURING THE PREVIOUS DAY
NO SEIZURE EPISODES
AWAKE LETHARGIC, RESPONDS TO LIGHT TOUCH, AND SOFT VOICE, NICRD
BP 100-120/60-80
HR 67-82
RR 19-20 O2SAT 95-99
TEMP 36.2 NO FEBRILE EPISODES
SCWE CBS
AP NRRR NO MURMURS
GCS 15, AWAKE LETHARGIC, ORIENTED TO PERSON, TIME, UNABLE TO IDENTIFY PLACE,
SPEAKS IN SENTENCES, WITH SLOW SPEECH
MOTOR - 5/5
SENSORY 100%
" pReportStatus="U" pDeficiencyRemarks=""/><COURSEWARD pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDateAction="2022-04-21" pDoctorsAction="	
CREATININE 97
MAGNESIUM	1.1
POTASSIU  M  4.28
RANDOM BLOOD SUGAR ( RBS )	6.89
 SGOT	5 - 34	65
AWAKE, GOOD APPETITE" pReportStatus="U" pDeficiencyRemarks=""/></COURSEWARDS><LABRESULTS><LABRESULT pHciCaseNo="" pPatientPin="" pPatientType="" pMemPin="" pEffYear=""><CBC pHciTransNo="" pReferralFacility="" pLabDate="" pHematocrit="" pHemoglobinG="" pHemoglobinMmol="" pMhcPg="" pMhcFmol="" pMchcGhb="" pMchcMmol="" pMcvUm="" pMcvFl="" pWbc1000="" pWbc10="" pMyelocyte="" pNeutrophilsBnd="" pNeutrophilsSeg="" pLymphocytes="" pMonocytes="" pEosinophils="" pBasophils="" pPlatelet="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><URINALYSIS pHciTransNo="" pReferralFacility="" pLabDate="" pGravity="" pAppearance="" pColor="" pGlucose="" pProteins="" pKetones="" pPh="" pRbCells="" pWbCells="" pBacteria="" pCrystals="" pBladderCell="" pSquamousCell="" pTubularCell="" pBroadCasts="" pEpithelialCast="" pGranularCast="" pHyalineCast="" pRbcCast="" pWaxyCast="" pWcCast="" pAlbumin="" pPusCells="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><CHESTXRAY pHciTransNo="" pReferralFacility="" pLabDate="" pFindings="" pRemarksFindings="" pObservation="" pRemarksObservation="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><SPUTUM pHciTransNo="" pReferralFacility="" pLabDate="" pDataCollection="X" pFindings="" pRemarks="" pNoPlusses="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><LIPIDPROF pHciTransNo="" pReferralFacility="" pLabDate="" pLdl="" pHdl="" pTotal="" pCholesterol="" pTriglycerides="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><FBS pHciTransNo="" pReferralFacility="" pLabDate="" pGlucoseMg="" pGlucoseMmol="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><ECG pHciTransNo="" pReferralFacility="" pLabDate="" pFindings="" pRemarks="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><FECALYSIS pHciTransNo="" pReferralFacility="" pLabDate="" pColor="" pConsistency="" pRbc="" pWbc="" pOva="" pParasite="" pBlood="" pOccultBlood="" pPusCells="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><PAPSSMEAR pHciTransNo="" pReferralFacility="" pLabDate="" pFindings="" pImpression="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/><OGTT pHciTransNo="" pReferralFacility="" pLabDate="" pExamFastingMg="" pExamFastingMmol="" pExamOgttOneHrMg="" pExamOgttOneHrMmol="" pExamOgttTwoHrMg="" pExamOgttTwoHrMmol="" pDateAdded="" pIsApplicable="N" pModule="" pDiagnosticLabFee="" pCoPay="" pReportStatus="U" pDeficiencyRemarks=""/></LABRESULT></LABRESULTS><MEDICINES><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="" pGenericName="CEFTRIAXONE + SULBACTAM ZEFTRAX S POWDER/VIAL 1.5GM" pGenericCode="" pSaltCode="" pStrengthCode="" pFormCode="" pUnitCode="" pPackageCode="" pRoute="IV" pQuantity="3" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="7956" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="EVERY 8 HOURS" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-15" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="LIDOC0000201314SOL3200060AMPUL" pGenericName="LIDOCAINE" pGenericCode="LIDOC" pSaltCode="00002" pStrengthCode="01314" pFormCode="SOL32" pUnitCode="00060" pPackageCode="AMPUL" pRoute="INTRAVENOUS" pQuantity="2" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="95.2" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="STAT/NOW" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-14" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="CEFTR0002000644SOL3200000VIALX" pGenericName="CEFTRIAXONE" pGenericCode="CEFTR" pSaltCode="00020" pStrengthCode="00644" pFormCode="SOL32" pUnitCode="00000" pPackageCode="VIALX" pRoute="INTRAMUSCULAR/ INTRAVENOUS" pQuantity="25" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="28687.5" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="TWO(2) X A DAY" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-21" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="" pGenericName="LEVETIRACETAM KEPPRA TABLET 500MG" pGenericCode="" pSaltCode="" pStrengthCode="" pFormCode="" pUnitCode="" pPackageCode="" pRoute="ORAL" pQuantity="4" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="419.16" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="EVERY 6 HOURS" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-21" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="5DLRS0000000000SOL3200247BOTTL" pGenericName="5% DEXTROSE IN LACTATED RINGER`S" pGenericCode="5DLRS" pSaltCode="00000" pStrengthCode="00000" pFormCode="SOL32" pUnitCode="00247" pPackageCode="BOTTL" pRoute="INTRAVENOUS" pQuantity="3" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="505.92" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="AS ROUTINE" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-15" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="PARAC0000000194SOL3200178VIALX" pGenericName="PARACETAMOL" pGenericCode="PARAC" pSaltCode="00000" pStrengthCode="00194" pFormCode="SOL32" pUnitCode="00178" pPackageCode="VIALX" pRoute="INTRAVENOUS" pQuantity="2" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="2006" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="AS NEEDED / AS DIRECTED" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-18" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="" pGenericName="VITAMINS + B COMPLEX NEUROBION  FORTE AMPULE 100MG/100MG/5MG/ML" pGenericCode="" pSaltCode="00000" pStrengthCode="00000" pFormCode="00000" pUnitCode="00000" pPackageCode="00000" pRoute="INTRAMUSCULAR" pQuantity="2" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="1224" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="AS NEEDED / AS DIRECTED" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-18" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE 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pTotalAmtPrice="12104" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="EVERY 8 HOURS" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-18" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="ESOM10000001025LPS0100000AMPUL" pGenericName="OMEPRAZOLE" pGenericCode="ESOM1" pSaltCode="00000" pStrengthCode="01025" pFormCode="LPS01" pUnitCode="00000" pPackageCode="AMPUL" pRoute="INTRAVENOUS" pQuantity="2" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="1909.36" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="ONCE A DAY" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-13" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="PARAC0000000047TAB490000000000" pGenericName="PARACETAMOL" pGenericCode="PARAC" pSaltCode="00000" pStrengthCode="00047" pFormCode="TAB49" 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pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="" pGenericName="VITAMIN B1 B6 B12 NEUROBION TABLET B-COMPLEX" pGenericCode="" pSaltCode="" pStrengthCode="" pFormCode="" pUnitCode="" pPackageCode="" pRoute="ORAL" pQuantity="16" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="574.24" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="TWO(2) X A DAY" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2022-04-21" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720220500103" pHciTransNo="C5012720220500103" pDrugCode="ESOM10000001025LPS0100000AMPUL" pGenericName="OMEPRAZOLE" pGenericCode="ESOM1" pSaltCode="00000" pStrengthCode="01025" pFormCode="LPS01" pUnitCode="00000" pPackageCode="AMPUL" pRoute="INTRAVENOUS" pQuantity="1" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="734.4" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="ONCE A DAY" pPrescPhysician="" 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