Polaroid

 

Bangladesh Homeopathic Medical College & Hospital- Dhaka

BHMS(35th)- Dhaka University

INVESTIGATION REQUEST FORM

PLAIN X-RAY

*Chest/Thorax- PA/AP/Both

*Skull- PA/AP/Both

*PNS- OM Vew

*Pituitary Fossa

*Orbits

*Mandible

*Maxilla

*Nasopharynx

*Abdomen- Supine

*Abdomen- Erect

*KUB

*Pelvis

*Cervical/Thoracic Spine

*L-S Spine

*Dorsal Spain

*Hip/Knee/Ankle Joint

*Wrist/Elbow/Shoulder Joint

*Other…………..

 

MRI

*Brain/Head/Skull

*Chest/Thorax- PA/AP/Both

*Lungs- Rt/Lt/Both

*Liver / Pancreas

*Kidneys- Rt/Lt/Both

*Whole Abdomen

*Upper Abdomen

*Lower Abdomen

*Hip/Knee/Ankle Joint

*Neck/Nasopharynx

*P.N.S- Om Vew

*Cervical/Thoracic/ L-S Spine

*Orbits

*Pelvis

*Other…………..

 

ULTRASOUND IMAGING- 4D

*Whole Abdomen & Pelvis

*Upper Abdomen

*Lower Abdomen

*HBS

*Uterus & Adnexae

*KUB/ Genito- Urinary Tract

*KUB with Prostate & Residual Volume

*Pregnancy Profile

*Chest

*Thyroid

*Brain

*Breast- Rt/Lt/Both

*Ear- Rt/Lt/Both

*Scrotum/Testes- Rt/Lt/Both

*Other…………….

 

MAMMOGRAM

*Both Breast

*Right Breast

*Left Breast

 

BMD (Bone Mineral Density)


 

CONTRAST X-RAY

*Full Myelogram

*Lumber Myelogram

* Cervical/Thoracic Myelogram

*O.C.G(Oral Colecysto Gram)

*T-Tube Colangiogram

*I.V.U/I.V.P

*Micturating Cystourethrogram

*Retrograde Cystourethrogram

*Ba. Meal Stomach & Deudenum

*Ba. Meal Swallow of Esophagus

*Ba. Meal Enema Colon-Plain

*Ba. Meal Enema Colon-Duble

*Fistulogram

*Sinogram/Sialogram

*Histero/Salphingogram

*Other……

 

OPG- Dental X-Ray

 

CARDIAC IMAGING

*ECG- 12 Lead

*Echocardiogram (2D & M-Mode)

*Dopplar Echo & Color Flow

*ETT- Treadmill Stress ECG

*Holter ECG (24Hour)

*Ambulatory BP Morning (24Hour)

 

VASCULAR STUDY

*Colour Doppler of………..

*Duplex Study of………..


 

SPECIAL PROCEDURE

*EEG- Electro Encephalo Gram

*Endoscopy of Upper G.I Tract

*Bronchoscopy

*Colonoscopy- Short/Full

*Broctoscopy

*Colposcopy

*TVS

*ERCP

*FNAC

*EMG

*NCV/NCS

*GFR

*Biopsy

*Uroflometry

*Other……….

 

CT SCAN

*Brain/ Head

*Chest/ Thorax

*HBS/ Pancreas

*Liver & FNAC

*Kidneys

*Whole Abdomen

*Upper Abdomen

*Lower Abdomen

*Cervical/Thoracic/ L-S Spine

*Orbites

*Pelvise

*Other….