<EPCB pUsername=":ECLAIMS-3.0-50127-DUMMY" pPassword="" pHciAccreNo="H01000908" pEnlistTotalCnt="1" pProfileTotalCnt="1" pSoapTotalCnt="1" pEmrId="" pCertificationId="ECLAIMS-3.0-50127-DUMMY" pHciTransmittalNumber="20250481"><ENLISTMENTS><ENLISTMENT pEClaimId="2504416B" pEClaimsTransmittalId="50127250481" pHciCaseNo="C5012720250400001" pHciTransNo="C5012720250400001" pEffYear="2025" pEnlistStat="1" pEnlistDate="2025-04-07" pPackageType="A" pMemPin="" pMemFname="" pMemMname="" pMemLname="" pMemExtname="" pMemDob="" pMemCat="" pMemNcat="" pPatientPin="190270633092" pPatientFname="KAI FN SEVENTEEN" pPatientMname="KAI MN SEVENTEEN" pPatientLname="KAI LNSEVENTEEN" pPatientExtname="" pPatientType="MM" pPatientSex="M" pPatientContactno="NA" pPatientDob="1974-01-18" pPatientAddbrgy="" pPatientAddmun="" pPatientAddprov="" pPatientAddreg="" pPatientAddzipcode="" pCivilStatus="U" pWithConsent="X" pWithLoa="X" pWithDisability="X" pDependentType="X" pTransDate="2025-04-08" pCreatedBy="8" pReportStatus="U" pDeficiencyRemarks="" pAvailFreeService="X"/></ENLISTMENTS><PROFILING><PROFILE pHciTransNo="C5012720250400001" pHciCaseNo="C5012720250400001" pPatientPin="190270633092" pPatientType="" pMemPin="" pProfDate="2025-04-07" pRemarks="" pEffYear="2025" 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="TESTING" 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="90" pHr="12" pRr="15" pTemp="36" pHeight="172" pWeight="50" pVision="" pLength="" pHeadCirc="" pReportStatus="U" pDeficiencyRemarks=""/><BLOODTYPE pBloodType="" pBloodRh="" pReportStatus="U" pDeficiencyRemarks=""/><PEGENSURVEY pGenSurveyId="1" pGenSurveyRem="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="" pAbdomenId="7" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="6" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="5" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="1" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="11" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="" pHeentId="" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="6" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PEMISC pSkinId="1" pHeentId="" pChestId="" pHeartId="" pAbdomenId="" pNeuroId="" pRectalId="" pGuId="" pReportStatus="U" pDeficiencyRemarks=""/><PESPECIFIC pSkinRem="" pHeentRem="" pChestRem="" pHeartRem="" pAbdomenRem="" pNeuroRem="" 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="C5012720250400001" pHciTransNo="C5012720250400001" pPatientPin="190270633092" pPatientType="MM" pMemPin="" pSoapDate="2025-04-07" pEffYear="2025" pSoapATC="CF4" pReportStatus="U" pDeficiencyRemarks=""><SUBJECTIVE pChiefComplaint="FOOT SWELLING" pIllnessHistory="TESTING" pOtherComplaint="FOOT SWELLING" pSignsSymptoms="X" 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="C5012720250400001" pHciTransNo="C5012720250400001" pDateAction="2025-04-08" pDoctorsAction="FOOT SWELL" 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="C5012720250400001" pHciTransNo="C5012720250400001" pDrugCode="" pGenericName="PARACETAMOL BIOGESIC 500MG TABLET" pGenericCode="" pSaltCode="" pStrengthCode="" pFormCode="" pUnitCode="" pPackageCode="" pRoute="ORAL" pQuantity="6" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="60" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="EVERY 4 HRS - AS NEEDED" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2025-04-07" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720250400001" pHciTransNo="C5012720250400001" pDrugCode="" pGenericName="CIPROFLOXACIN (GMAP) CIPROBAY 250MG TABLET PIECE" pGenericCode="" pSaltCode="" pStrengthCode="" pFormCode="" pUnitCode="" pPackageCode="" pRoute="ORAL" pQuantity="1" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="59" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="AS NEEDED / AS DIRECTED" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2025-04-07" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/><MEDICINE pHciCaseNo="C5012720250400001" pHciTransNo="C5012720250400001" pDrugCode="" pGenericName="PLAIN LR 1 LITER EUROMED  PIECE" pGenericCode="" pSaltCode="" pStrengthCode="" pFormCode="" pUnitCode="" pPackageCode="" pRoute="IV" pQuantity="1" pActualUnitPrice="" pCoPayment="" pTotalAmtPrice="276" pInstructionQuantity="" pInstructionStrength="" pInstructionFrequency="AS NEEDED / AS DIRECTED" pPrescPhysician="" pIsApplicable="Y" pDateAdded="2025-04-07" pModule="CF4" pReportStatus="U" pDeficiencyRemarks=""/></MEDICINES></EPCB>
