Printable Medical Summary — Your Wallet Emergency Card
If you're unconscious or too ill to speak, this card tells paramedics and clinics what matters: your conditions, medications, allergies, blood type, and who to call. Fill the fields below (they stay on your device), then print — it fits on one page.
⚕️ MEDICAL SUMMARY — मेडिकल सारांश
In emergency, please contact Thamel Clinic: +977-9747726036 · Ambulance: 102
| Full Name / नाम | ________________________________ |
|---|---|
| Date of Birth / जन्म मिति | ________________ |
| Blood Type / रक्त समूह | __________ |
| Medical Conditions / स्वास्थ्य अवस्था | ________________________________ |
| Daily Medications / दैनिक औषधि | ________________________________ |
| Allergies (drugs/food) / एलर्जी | ________________________________ |
| Emergency Contact / आपत्कालीन सम्पर्क | Name: ______________ Phone: ______________ |
| Travel Insurance / यात्रा बीमा | Insurer: ____________ Policy #: ____________ |
| Home Doctor / आफ्नो डाक्टर | Name: ______________ Phone: ______________ |
How to Use It
- Click any blank cell and type — the text is editable in your browser before printing.
- Fill ALL fields — "NKDA" (no known drug allergies) is itself critical information.
- Print two copies: one in your wallet, one in your backpack's outer pocket.
- Laminate at a Thamel print shop (~NPR 50) or cover in clear tape — it survives rain.
- Update it whenever your medications change.
The Records That Travel
The care you received in Kathmandu does not end at the border — your home physician needs to know what was diagnosed, what was prescribed, and what follow-up is recommended. The medical summary request produces the complete record — the continuity of care that the return home requires.
Request your records when
- Leaving Nepal — collect before departure
- Filing insurance claims — the documentation insurers require
- Following up at home — your doctor needs the records
- Chronic condition management — ongoing care needs the history
- Personal records — your medical file travels with you
Format and Delivery
Digital PDF (emailed or downloadable) or printed copies — English-language, internationally formatted, suitable for any healthcare system. Most requests complete within 1–2 business days; urgent requests before departure can be expedited.
The Summary Cost
Medical summary form — the free (the printable that is provided). For the home-doctor handoff, the document that is carried.
The Value
Summary value — the continuity (the home physician that reads the visit record). For the ongoing condition, the documented that prevents the repeat work.
What is the medical summary form?
A request for your medical records — consultation notes, test results, imaging reports, vaccination records, and treatment summaries from your visits to Thamel Clinic. For your home doctor, insurance claims, or personal records.
Why would I need my medical records?
For continuity of care at home — your physician needs the records of what was diagnosed and treated abroad. For insurance claims — the documentation insurers require. For your own records — the history that future providers may need.
How long does records request take?
Most requests are completed within 1–2 business days — the records are pulled, compiled, and provided digitally or in print. For urgent requests (departure imminent), we can often expedite.
What format do the records come in?
Digital PDF (emailed or downloadable) or printed copies — your choice. The records are in English with international-standard formatting suitable for any healthcare system or insurer.
Is there a charge for records?
Standard records requests for your own records or continuity of care are typically provided without charge or minimal fee for printing/administrative costs. Extensive record compilation or specific certificate requests may have associated fees.
