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Patient Referral for Schizophrenia Evaluation

The document is a referral form for a 26-year-old male patient named Naif Ali Marzouq Al-Mutairi, diagnosed with schizophrenia and presenting with muscle wasting and hypotonia. The referral is from Dr. Mohamed Amin in the psychiatry department to the neurology department at Prince Mohamed Abdalaziz Hospital for further evaluation. The patient is currently on medications including Depakin, Procyclidine, and Olanzapine.

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54 views1 page

Patient Referral for Schizophrenia Evaluation

The document is a referral form for a 26-year-old male patient named Naif Ali Marzouq Al-Mutairi, diagnosed with schizophrenia and presenting with muscle wasting and hypotonia. The referral is from Dr. Mohamed Amin in the psychiatry department to the neurology department at Prince Mohamed Abdalaziz Hospital for further evaluation. The patient is currently on medications including Depakin, Procyclidine, and Olanzapine.

Uploaded by

raad_alghamdi_1
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd

Health Care No 160453 ‫الرقم الصحي‬

Name ‫نايف عالي مرزوق المطيري‬ ‫االسم‬


Age 26 years ‫العمر‬ Sex male ‫الجنس‬
Nationality saudi ‫الجنسية‬
Hospital : ERADAH COMPLEX - Riyadh ‫االستشاري‬
Consultant In-charge Dr: kilani ‫المسئول‬
.Dept Psychiatry ‫القسم‬ Unit opd ‫الوحدة‬

DOC_STATUS> REFERRAL FORM< ‫نـمــوذج تـحـــــويـــــــل‬


TO DR ER DEPT Neurology department
DESIGNATION HOSPITAL / PHC Prince mohamed abdalaziz hospital
FROM DR Dr: mohamed amin DEPT psychiatry
DESIGNATION HOSPITAL / PHC ALAMAL COMPLEX IN Riyadh
CLINICAL HISTORY :
k/c of k/c of schizophrenia , presented with muscle wastinig and hypotonia , decrease apetite , on wheel
chair

PHYSICAL EXAMINATION :
Muscle waistinig , hypotonia

INVESTIGATIONS :
nil

PROBLEMS / DIAGNOSIS :
k/c Schizophrenia
Muscle waisting and hypotonia for neurological evaluation

TREATMENT/ PROCEDURES DONE SO FOR :


Depakin 500 mg po bid
Procyclidine 5 mg po bid
Olanzapine odt 10 mg po bid
PATIENT'S CONDITION : <PATIENT_CONDITION>
REASON FOR REFERRAL : <REASON_FOR_REFERRAL>
TRANSPORTATION : <TRANSPORTATION>
ESCORT : <ESCORT>
DOCUMENTS SENT : <DOCUMENTS_SENT>
Dr.'s Name Dr: mohamed amin
Date : 21/11/2019
Mobile # 0566203437

Print time :<CURRENT_DATE> <CURRENT_TIME> By User ID :<USER_CREATED> DOCUMENT_ID # <DOCUMENT_ID>

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