It was the wish of our founder Fr Augustus Muller, S.J., that the patients who are unable to visit our Institutions for treatment, be helped through Postal Correspondence. Accordingly, every year we have been attending to thousand of patients through Postal correspondence all over the world getting thereby desired results.

It is our sincere desire as well as endeavor to continue to help the needy and suffering patients providing proper diagnosis and quality care through medicines in shortest period.

Our clients who make use of Postal correspondence are requested to send us their case history in the prescrbed form supplied by the institution. The case history of the patient will be carefully studied and examined by the learned doctors of our Homeopathic Medical College. The medicines, with specific instructions, are sent to patients for a nominal cost. The patients are also hereby informed that their case history as well as the prescription will be treated as confidential. They are requested to extend their wholehearted co-operation.

Please write with details to:

Administrator,
Father Muller Homeopathic Medical College & Hospital
University Road, Deralakatte 
Mangalore - 574 160. Karnataka, India
Telephone : (0824) 2203901/ 2203902
Email: mullerhmc@yahoo.co.in/  mullerhpd@bsnl.in
Fax : (0824) 2203904/2203403
Website : www.fathermuller.com

Father Muller Homoeopathic Medical College

Out-Patient Dept.

Mangalore – 575 002

MEDICAL HISTORY FOR HOMOEOPATHIC TREATMENT

Directions for a Written Submission

INTRODUCTION

1. For finding out a correct Homoeopathic Remedy, lot of information with regard to the (i) Complaints – (a) Main as well as (b) Subsidiary – and (ii) the Person of the patient is required.
2. Incomplete information will make correct choice difficult.  You are therefore requested to supply all information without keeping back anything as irrelevant or of little importance.  The information you supply in the Note forms the basis of further enquiry designed to assist you in the further delineation of the problem.  Full co-operation, therefore, is requested.  All information supplied is, of course, strictly confidential.
3. Since the enquiry can be time consuming process and a lot of information is being collected we require to record it systematically and, at times we may find it necessary to administer to you further tests in which you are called upon to write preliminary study is carried out by a physician specially assigned to this job and when your Case Record is ready, we examine it to find out if it is sufficient for instituting treatment or it requires further detailed processing of information and study of your Case, if so, we give you a further suitable appointment for finalizing the line of treatment.
4. We are sure you shall be fully co-operating with us in rendering you the best possible service.

PRELIMINARY INFORMATION

Please supply the following information as standard routine : Name in full; Date of Birth; Sex; Status, Single/Married or Widow-ed since/Divorcee since / Religion / Community / Sect; Vegetarian / Non-Vegetarian / Eggs’ Addictions; Tobacco; Chewing / Smoking, Tea, Coffee, Beer, Whisky & Liquors (please state the quantity consumed).  Educational career and qualifications.   Occupation; current and previous / with a full description of responsibilities and job-satisfaction; address and Tel. No.

Description of the current family set-up; full details pertaining to all the members their ages, location, work they are doing and your relationship with responsibilities for them.  Include in your list those who have died, stating the age of death, the year and cause of the same.

Your daily routine from getting up in the morning to retiring at night.  Include in this your dietary schedule furnishing full details in respect of the quantities consumed.  Financial responsibilities and strain (present as well as past), Difficulties experienced.  Place of work Family set up / Social: give a full account.

CHIEF COMPLAINT

Describe fully what bothers you most.  Each trouble should be detailed as under:

1. Full description of the trouble right from the time of onset, its subsequent development and spread and response to treatments taken.  This should give full idea of:

(i)    Area affected: location, extension, direction of spread, the march of events.

(ii)  Sensation experienced in the area of trouble

(iii) Conditions that have brought on the trouble; examine the circumstance that obtained just before or at the time of onset, paying attention to physical as well as emotional factors.

(iv)                       Conditions that increase the trouble or those that afford relief.

(v) Other troubles experienced at the same time along with the main trouble for example ……. Perspiration / nausea / vomiting / gas / with pains.

OTHER COMPLAINTS

Describe here all other troubles you might be having or have in the past experienced.  Each should be described fully as suggested above for the ‘Chief Complaint’.

PERSONAL DATA

Give a gull account of the following:

(i)                            Physical description of self.

(ii)                          Emotional nature and intellectual attainments and aspirations.  Indicate to what extent you have been able to realize them.  Give a clear –cut picture of your relationships with the family members, friends and associations.  Give a full idea of your responsibilities in life and what you feel about them.

(iii)                         Reactions to surroundings.

(a)             Food” desires and aversions food, that do not suit, etc.

(b)             General environment: weather, temperature, bath, recreations, addictions etc.,

(c)             Sleep and Dreams

(d)             Sex (inclusive of menstrual and obstetric history)

Previous Illness

Give a resume of the various illnesses you had and to what extent these have any bearing on present troubles.

Family History

Data concerning the Parents, Brothers and Sisters.  State details concerning the health of wife and children.

General Comments

Include here any items which have not been included above.

Enclosures

1.     Medical Report and opinion on your state of health from your physician.

2.     Copies of Reports of Investigations done.

3.     X-ray plates, Electrocardiograms, etc.

PRESENTATION

Your History is to be filled in the standardized Case Record which we employ.  To facilitate that, you are requested to follow the directions given so that we do not have difficulties in filling.  Number of pages serially.

7"

7" Reverse Side

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1  1/2" Margin left Side

TOP

1 1/2" Margin for Punching

1 1/2" Margin left Side

1st line starts here at this end

1st line starts here at this end

Lined Paper

Lined Paper

SIDE Reverse

Write here

SIDE

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BOTTOM

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Clinic Address

Appointment on

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Correspondence Address

Clinic ………………….