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Lyse - India Registry
Name of Patient
*
Name of Hospital
*
Hospital ID
*
Citizen
*
Select Citizen
Indian
Non Resident Indian
Foreigner
Age
*
Past History
T2DM
Sys.HTN
DLP
Obesity
Smoker
Family history of CAD
Press 'Ctrl' buttom to select more than one.
Sex
*
Select Sex
Male
Female
State
*
Select State
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Pondicherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttaranchal
Uttar Pradesh
West Bengal
STEMI
Anterior
Posterior
Lateral
Septal
Inferior
RVMI
Press 'Ctrl' buttom to select more than one.
Drug Used
*
Select Drug Used
STK
TNK t-PA
Urokinase
After Lysis Plan
*
Select After Lysis Plan
Referred to PCI capable center
Inhospital PCI
Prognosis at 1 week
*
Select Prognosis at 1 week
Expired
For CABG
PCI done
For Medical Management
NOTES
*
Treating Doctor
*
MBBS PGDCC
Date of Lysis
Enter the sum of numbers & submit
Submit
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