Obst History
G :
{$infertilitysheet->obstg}
P :
{$infertilitysheet->obstp}
FT :
{$infertilitysheet->obstft}
PT :
{$infertilitysheet->obstpt}
EPC :
{$infertilitysheet->obstepc}
LIVING :
{$infertilitysheet->obstliving}
Infertility Sheet
{$infertilitysheet->importantnotes}
Infertility Sheet
Type
Duration
Year
Month
husband
Diagnosis
History
Travel abroad
Location
Duration
In
Out
Medical History
Surgical History
Examination
General (BW)
Local
Investigations
Semen
Date
PLace
Type
C
PRM
TM
AF
VIT
Vol
TZI
SDI
{foreach $semen as $single}
{/foreach}
Other Inv
Scrotal U/S
TRUS
Karyo
Yq micro
SDF
Semen Fr
TESE
Other
{foreach $semen2 as $single}
Date
PLace
Result
C
M
AF
{/foreach}
Hormonal Profile
FSH
LH
TT
PRL
E2
Inhibin B
Other
Other
{foreach $hormonalprofile as $single}
Date
Result
{/foreach}
TTT
WIFE
Diagnosis
History
Menstrual History
Sexual History
Reg
C/D
Amount
Dysm
LMP
Medical History
Surgical History
Family History
(Obst History) p
Sex
Name
Date of D
Age
Mode of D
Type of D
W
L
Obst
CO
Method
Duration
Stopped
Comment
{foreach $awifep as $single}
{$single->wifeage}
wifel == 1} checked {/if}>
{/foreach}
EPC
Last
date
Type
W
TTT
Obst
Histopath
cost
p
Epc
{foreach $wifeepc as $single}
{/foreach}
Examination
General
Local
BW
Vulva
BMI
Vagina
Breast
CX
Hirsutism
Other
Thyroid
Other
Investigations
Hormonal Profile
AMH
TSH
PRL
FSH
LH
E2
P4
Other
{foreach $hormonalprofile2 as $single}
Date
Result
{/foreach}
TVS
{foreach $tvs as $single}
Date
UT
CX
RO
LO
Pelvis
{/foreach}
3D TVS
Date
Place
Result
{foreach $dtvs as $single}
{/foreach}
SIS
Date
Result
{foreach $sis as $single}
{/foreach}
HSG
Date
PLace
UT
RT
LT
Pelvis
{foreach $hsg as $single}
{/foreach}
Hysteroscopy
Date
PLace
Dil
Introd
CX
Cavity - Fundus
R-Ostium
L-Ostium
{foreach $hysteroscopy as $single}
Intervention
{/foreach}
Laparoscopy
Date
PLace
UT
RT
LT
RO
LO
Pelvis
{foreach $laparoscopy as $single}
Intervention
{/foreach}
Other
Name
Date
Details
{foreach $infertilityother as $single}
{/foreach}
Lab
Lab
Add
Show
TTT
DA
Metformin
COS
Type
Response
IUI
Trials
Date
Result
ICSI
Date
PLace
Protocol
OPU
Semen
Fert
S.S
ET
D
Fr
Re Fr
E2d2
Result
{foreach $icsi as $single}
{/foreach}
FOLLICULOM
LMP
TTT
CD
Date
RO
LO
Endo
Pelvis
TOO
Result
{foreach $folliculom as $single}
{/foreach}
operations
operation
Date
place
histopath
Cost
notes
{assign var="i" value="1"} {foreach $operations as $single}
{$i}
{assign var="i" value=$i+1} {/foreach}
PLan
Husband
Wife
New Visit
{foreach $newvisit as $single}
Date
Cycles
LMP
BW
usvsdtv eq 1} checked {/if} >US
usvsdtv eq 2} checked {/if} >TVS
usvsdtv eq 3} checked {/if} >3D TVS
UT
OV
TTT (Button)
TTT
Add
Show
Notes
{/foreach}
Today
Add
Add New Drug
Husband
Print Date
Group
Drug
Form
Use
Delete
{assign var=itr value=1} {foreach $PatientPresByDate as $pre}
drugcat == ""}selected{/if}>Choose Category
{foreach $allDrugcats as $cat}
drugcat == $cat['drugcat'] }selected{/if}>{$cat['drugcat']}
{/foreach}
drugcat == ""}selected{/if}>Choose Category
drugid == ""}selected{/if}>Choose Drug
{foreach $drugs as $drug}
drugid == $drug['id'] }selected{/if}>{$drug['drugname']} {if $ProgramesettingData->visitsform eq 3}(left {$drug['currentbalance']}){/if}
{/foreach}
drugid == ""}selected{/if}>Choose Drug
drugtype == ""}selected{/if}>Choose Form
{foreach $allDrugTypes as $type}
drugtype == $type['drugtype'] }selected{/if}>{$type['drugtype']}
{/foreach}
drugtype == ""}selected{/if}>Choose Form
drugdos == ""}selected{/if}>choose dose
{foreach $allDrugDoses as $dos}
drugdos == $dos['drugdos'] }selected{/if}>{$dos['drugdos']}
{/foreach}
drugdos == ""}selected{/if}>choose dose
{capture assign=itr}{$itr+1}{/capture} {/foreach}
Prescriptions
Date
Drug Name
Edit
Print
{if $ProgramesettingData->displaydoctorname eq 1} Doctor{/if}
Today
Save
Save and Print
Close
Husband
Print Date
{assign var=i value=1} {foreach $group1 as $cat}
{$cat->name}
{assign var=j value=1} {foreach $cat->invests as $inv}
{$inv->name}
{capture assign=j}{$j+1}{/capture} {/foreach}
{capture assign=i}{$i+1}{/capture} {/foreach}
{assign var=i value=1} {foreach $group2 as $cat}
{$cat->name}
{assign var=j value=1} {foreach $cat->invests as $inv}
{$inv->name}
{capture assign=j}{$j+1}{/capture} {/foreach}
{capture assign=i}{$i+1}{/capture} {/foreach}
{assign var=i value=1} {foreach $group3 as $cat}
{$cat->name}
{assign var=j value=1} {foreach $cat->invests as $inv}
{$inv->name}
{capture assign=j}{$j+1}{/capture} {/foreach}
{capture assign=i}{$i+1}{/capture} {/foreach}
{assign var=i value=1} {foreach $group4 as $cat}
{$cat->name}
{assign var=j value=1} {foreach $cat->invests as $inv}
{$inv->name}
{capture assign=j}{$j+1}{/capture} {/foreach}
{capture assign=i}{$i+1}{/capture} {/foreach}
Favorites
{assign var=j value=1} {foreach $favorites as $inv}
{$inv->name}
{capture assign=j}{$j+1}{/capture} {/foreach}
{foreach $others as $cat}
{$cat->name}
{assign var=j value=1} {foreach $cat->invests as $inv}
{$inv->name}
{capture assign=j}{$j+1}{/capture} {/foreach}
{capture assign=i}{$i+1}{/capture} {/foreach} {assign var=i value=1} {foreach $group5 as $cat}
{$cat->name}
{assign var=j value=1} {foreach $cat->invests as $inv}
{$inv->name}
{capture assign=j}{$j+1}{/capture} {/foreach}
{capture assign=i}{$i+1}{/capture} {/foreach}
Investigations
Date
Investigations