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| "file_name": "cf1.png", | |
| "text": "THE PRINCE PHILIP DENTAL HOSPITAL\n菲臘牙科醫院\n\nSurgical Consent Form\n手術同意書\n\n1. I (HKID Card / Passport Number)\n本人 (Name in Block Letters) (請用正楷填寫姓名) (香港身份證 / 護照號碼)\n\nhereby consent to myself / my child* undergoing the operation of\n茲同意本人 / 子女* (Name of minor under 18) (十八歲以下子女姓名) 接受\n\n脫牙 18 and the administration of local or other anaesthetics.\n手術及施行局部或其他麻醉。\n\n2. The nature, purpose, risks and complications of the surgery have been explained to me by the following\nperson(s) :\n有關手術之性質、效果、風險及可能引起之併發症已由以下人士向本人清楚解釋 :\n醫生\n\nRN/CDSA 傳譯\n\n3. I also consent to further or alternative operative measures as may be found to be necessary or advisable\nduring the course of this operation.\n手術期間，如須施行進一步或另一項手術，本人亦同意進行。\n\n4. I understand that no assurance has been given that the operation will be performed by any particular\ndental surgeon.\n本人更明悉該項手術並無特別保證由某位牙科醫生施行。\n\nI am /am not* willing to allow the extracted teeth or other tissues of myself / my child* to be used for research.\n本人願意 / 不願意* 讓本人 / 子女* 脫下之牙齒或其他組織作為研究用途。\n\n16-01-2020\nDate\n日期\n\n*Please delete as appropriate 請將不適用者刪去\nPPDH 302 (Revised 16.9.04)" | |
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| "file_name": "hd1.png", | |
| "text": "The Prince Philip Dental Hospital 菲臘牙科醫院\nHealth Declaration 健康申報表\n\nName 姓名: Identification Document No. \n身份證明文件號碼 :\nPhone Contact Record No. (if any)\n聯絡電話: 病歷編號 (如適用) :\n\nA. SYMPTOMS 病徵 NO 無 YES 有 If Yes, number of days 如有，日數\n1. Fever 發燒 (>37.5C) N\n2. Chills & Tremors 發冷 N\n3. Cough 咳嗽 N\n4. Diarrhoea 肚瀉 N\n5. Shortness of Breath / Difficulty in Breath N\n呼吸急促 / 呼吸困難\n6. Sore Throat 喉嚨痛 N\n7. Malaise 精神萎靡 N\n8. Myalgia 肌肉痛 N\n9. Other Symptoms (Please specify) \n其他病徵 (請列明)\n\nPlease provide the following information 請提供以下資料 :\nB. Have you ever been diagnosed with COVID-19? (If yes, please specify name of hospital admitted and\ndate of discharge) 曾否確診 2019 冠狀病毒病? (如有，請列明入住醫院及出院日期)\nNo\n\nC. Travel history within past 14 days (Please specify the dates and city / province / country)\n過去十四天內的旅遊紀錄 (請列明日期和城市 / 省份 / 國家)\nNo\n\nD. Have you visited hospitals or quarantine camp, or been in close contact with person(s) who is/are inbound\ntravellers* or identified as suspected carriers/ confirmed patients suffering from COVID-19 within past 14\ndays? (Please specify name of hospitals/ quarantine camp/ countries and cities visited)\n過去十四天內曾否到訪醫院或隔離營或與海外抵港人士*或 2019 冠狀病毒病疑似帶菌者或確診病\n患者有密切接觸? (請列明醫院/隔離營/到訪國家及城市)\nNo\n\nE. Have you been in a 14-day self-quarantine within past 2 months? (If yes, please specify the period)\n過去兩個月內曾否接受自我隔離十四天? (如有，請註明日期)\nNo\n\nDeclaration 聲明:\n1. I hereby declare that all information provided above is true and accurate. 本人證實上述資料正確無訛。\n2. I hereby authorise The Prince Philip Dental Hospital or its representatives to obtain my medical records of the past 2 months\nfrom relevant health departments/ agencies of the HKSAR Government and agree to provide necessary information in\nrelation to the application of the records. 本人授權菲臘牙科醫院或其代表可向香港政府有關衞生部門或機構索取本\n人最近兩個月的病歷紀錄，並會提供申請紀錄時所需要的資料。\n3. The above data may be sent to the relevant health departments/ agencies of HKSAR Government for appropriate follow-up\nactions. 以上資料可能會交予香港政府有關衞生部門或機構作出跟進。\n\nSignature 簽名 : Date 日期 : 11 MAR 2021\n[If you are signing for the patient, please 為父母或監護人替病人簽署，請提供以下資料:\n(i) Name in BLOCK letter 姓名:____________________;\n(ii) Identification Document No. 身份證明文件號碼:____________________; (iii) Relationship with patient 與病人之關係:____________________]\n\n*Family members, friends or relatives co-living in the same residency who have been visiting or studying abroad and returned to Hong Kong in the past 14 days\n過去 14 天內曾到訪其他國家或留學返港的同住家庭成員、朋友及親戚" | |
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| "file_name": "hw1.png", | |
| "text": "Date DAY SHEET Initials\n15, 16, 17 grossly carious and TTP.\nTx: explained need for 15, 16, 17 removal.\nInformed of risks of OAC, maxillary sinusitis,\nORN.\nadvised to seek private dentist for restoration of\nother carious teeth asap and to improve OH.\n17 JUL 2020 OMFS CONSULT\nPATIENT CANCELLED APPOINTMENT\n14 AUG 2020 OMFS CONSULT\nPATIENT CANCELLED APPOINTMENT\n12 OCT 2020 OMFS CONSULT\nPATIENT FAILED APPOINTMENT\nPatient declined extractions, will seek private dental\ncare. Discharge from OMFS" | |
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| "file_name": "pn1.png", | |
| "text": "Print at: 2020-01-16\nPage No.: 1\n\nPatient Appointment Summary\nHospital No.:\nAppointment Date: 2020-01-16 14:30\nName:\nClinic: 750\n\nProgress Note\n\nChief Complaint\nRefer from RPC for the extraction of 18,28.\n\nHistory of Present Complaint\nPain on 18.\n\nClinical Exam\n18 PE\n28 extracted last week, wound healing satisfactory.\n\nTreatment\nExtraction of 18.\nExplained the risk of root fracture and oral-antral communication.\nInformed consent obtained.\n\nLA: 2% xylestesin 1:80000 adrenaline , B and P local infiltration. 1 cart.\n18 removed with warwick james elevator.\n\nHemostasis achieved.\n\nPOi given.\nRx: Paracetamol 500mg qid prn po X 4 tabs\n\nTo Come Again\nDischarged. From OMFS\n\nOperator Signature:\n\n2020-01-16" | |
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| "file_name": "rl1.png", | |
| "text": "康頤牙科醫務中心\nMark & Richard Dental Centre\n\nReferral Letter\nDate: 2020年12月2日\n\nOral and Maxillofacial Surgery - Consultation Clinic\n\n2/F, The Prince Philip Dental Hospital\n34 Hospital Road, Sai Ying Pun, Hong Kong\nTel: 2859 0263/ 2859 0387\n\nDear Doctor,\n\nRe: M / 65\n\nPlease kindly see the above named patient who is suffering from right side tooth pain. Mr\nLeung had history of nasopharyngeal cancer and had undergone treatment. Multiple root\ncaries were found. OPG was taken, multiple teeth were found unrestorable. Referral to\nOMFS and prosthodontic care was suggested.\n\nPlease kindly give your expert management.\n\nOMFS E8 JAN 2021.\nStaff 4/2/2021\nHDO\nJHDO\nBDS IV V VI\nSignature MDS III 18/2/2021\n 2:00" | |
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