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Home > Survey-2014 for IACC Members

Survey-2014 for IACC Members

Title:*
Name:*

Age:*

Sex:*
MaleFemale
Qualification:*
Place Of Work:*
UrbanSemi-UrbanSemi-RuralRural
Hospital Address:
Residential Address:(For IACC Office data)
IACC Membership No :

Number of CAD patients under your care indepentently :*
/ Month
Number of HTN patients :*
/ Month
Number of DM patients :*
/ Month
Number of congenital heart disease patients diagnosed by you :*
/ Month
Number of post PCI patients under your follow up :*
/ Month
Number of post CABG / valve replacement patients under your follow up :*
/ Month
Number of Echo cardiograms performed by you :*
/ Month
Number of TMT performed by you :*
/ Month
Number of patients diagnosed as new CAD by you :*
/ Month
Number of ACS patients referred by you for emergency PCI :*
/ Month
Others: (Please mention)*
Number of post PCI patients under your care :*
/ Month
Number of patients undergoing thrombolysis under your care :*
/ Month
Number of heart failure patients managed by you :*
/ Month
Number of arrhythmia patients managed by you :*
/ Month
Number of cardiopulmonary arrest managed by you :*
/ Month