Patient Details

Mr/Mrs/Miss/Dr	Mr. Mrs. Miss Master Baby Dr
Surname
First Name
Age
Address
Telephone
Surgery	R/Modified Radical Mastoidectomy L/Modified Radical Mastoidectomy R/Cortical Mastoidectomy and Myringoplasty L/Cortical Mastoidectomy and Myringoplasty R/Stapedectomy L/Stapedectomy L/Myringoplasty R/Myringoplasty Parotidectomy FESS DL & Biopsy ML Rigid Oesophagoscopy Panendoscopy Thyroplasty Tracheostomy Cervical Lymphnode Biopsy Thyroglossal Cyst Excision Tonsillectomy Adenoidectomy Myringotomy and Grommet insertion Septoplasty Nasal Polypectomy MUA Other
Surgery Date
Time of the Surgery	5AM 6AM 7AM 8AM 9AM 10AM 11AM 1PM 2PM 3PM 4PM 5PM 6PM 7PM 8PM 9PM 10PM
Hospital	Nawaloka Hospital Asiri Surgical Hospital National Hospital of Sri Lanka Golden Key Eye and ENT Hospital
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