Dr N.R.S.
GOVERNMENT AYURVEDIC COLLEGE
VIJAYAWADA
DEPARTMENT OF PANCHAKARMA
CASE SHEET OF PANCHAKARMA
Name of the patient: D.O.A:
Age& Gender: D.O.D:
Occupation: Bed No:
Address: OP/IP No:
Provisional diagnosis:
Differential diagnosis: Result:
Final diagnosis:
1 .PRADHANA VEDANA & KALA:
2. ANUBANDHA LAKSHANAS:
3. ATURA ITIVRITTAM:
i) Poorva Vyadhi Itivrittam:
ii) Parivarika Itivrittam:
iii) Vyaktigata ItiVrittam:
Diet: Smoking:
Habits: Alcohol :
Others:
4. GENERAL EXAMINATION:
Pulse:
Blood Pressure:
Temperature:
5. SYSTEMIC EXAMINATION:
6. INVESTIGATIONS
General:
Specific:
7. NIDANA& SAMPRAPTI:
8. PROVISIONAL DIAGNOSIS:
9 .DIFFERENTIAL DIAGNOSIS:
10. FINAL DIAGNOSIS:
11. UPADRAVA - ARISTA:
Upadrava:
Arista Lakshanas:
12. SADHYA-ASADHYA VICHARANA:
CHIKITSA
CHIKITSA SUTRAM:
1. SODHANA
A. POORVA KARMA:
B. PRADHANA KARMA:
C. PASCAT KARMA:
2. SHAMANA:
Drug Dose Anupana Samaya
3. SPECIFIC INSTRUCTIONS:
a. AHARA:
b. VIHARA:
Signature of Student Signature of Faculty