Dr Rakesh Khandel

Dr Rakesh Khandel

MBBS
Pediatrics
5 245 ratings

About Me

Dr Rakesh Khandel

MBBS
Pediatrics
10 Years Experience

Biography

Dr. Rakesh Khandel is a dedicated and compassionate pediatrician with over 10 years of experience in caring for the health and well-being of children from infancy through adolescence. He holds a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree and has built a strong reputation for providing personalized, family-centered care that addresses both the physical and emotional needs of young patients. Throughout his career, Dr. Khandel has been deeply committed to guiding children and their families through every stage of growth and development. He understands that each child is unique and requires an individualized approach to healthcare. His warm and approachable manner helps put children and parents at ease, making visits to the clinic less stressful and more supportive. Dr. Khandel believes that building a trusting relationship with his patients and their families is a vital part of effective healthcare. Dr. Khandel’s expertise covers a wide range of pediatric services including routine immunizations, growth and developmental assessments, management of common childhood illnesses, nutritional counseling, and treatment of chronic conditions such as asthma and allergies. He is skilled in early identification of developmental delays and behavioral concerns, providing timely interventions that help children reach their full potential. Additionally, he stays up to date with the latest advancements in pediatric medicine to ensure his patients receive the best care possible. Parents appreciate Dr. Khandel’s clear and patient explanations of medical conditions and treatment options. He takes the time to listen carefully to concerns and encourages open communication, empowering families to make informed decisions about their child’s health. Recognizing that the health of a child is closely linked to the family environment, he often offers advice on preventive care, healthy lifestyle choices, and safety measures both at home and school. Dr. Rakesh Khandel is not only a trusted healthcare provider but also someone who genuinely cares about his patients’ futures. Whether addressing an acute illness or managing a long-term health issue, he approaches every case with attention, kindness, and professionalism. Families seeking a knowledgeable and empathetic pediatrician will find Dr. Khandel a supportive partner in ensuring their children thrive in good health.

My Clinic

OPD Hours

Monday Morning 10:00 AM - 02:00 PM
Evening 06:00 PM - 09:00 PM
Tuesday Morning 10:00 AM - 02:00 PM
Evening 06:00 PM - 09:00 PM
Wednesday Morning 10:00 AM - 02:00 PM
Evening 06:00 PM - 09:00 PM
Thursday Morning 10:00 AM - 02:00 PM
Evening 06:00 PM - 09:00 PM
Friday Morning 10:00 AM - 02:00 PM
Evening 06:00 PM - 09:00 PM
Saturday Morning 10:00 AM - 02:00 PM
Evening 06:00 PM - 09:00 PM
Sunday Morning 10:00 AM - 02:00 PM
Evening 06:00 PM - 09:00 PM

Treatments

Specialised care and treatments offered

VACCINATION & CHECK-UP

Vaccination & Check-Up

Vaccinations and regular check-ups are essential parts of pediatric care, protecting children from serious illnesses and ensuring healthy development. Pediatricians follow immunization schedules to provide timely protection against diseases like measles, polio, and whooping cough. Routine check-ups allow for monitoring of growth, development, and early detection of potential health issues. These visits also give parents an opportunity to discuss nutrition, behavior, sleep, and safety. Through vaccinations and consistent medical evaluations, pediatricians help build a strong foundation for lifelong health and well-being. Preventive care not only keeps children safe but also supports their physical and emotional development.

INFECTIOUS DISEASES

Infectious Diseases

Expertise in managing acute respiratory infections, pneumonia,  bronchiolitis, typhoid fever, urinary infection, diarrhoea, fungal skin infections, sepsis/ blood infection, viral infections like chicken pox, measles, viral hepatitis, mumps, child with rash etc

GROWTH AND DEVELOPMENT

Growth and Development

Growth and development are key indicators of a child's overall health and well-being. For pediatricians, monitoring these aspects involves assessing physical milestones such as height, weight, and head circumference, as well as developmental progress in motor skills, language, cognition, and social interaction. Regular check-ups help identify any delays or concerns early, allowing for timely interventions. Growth charts, developmental screenings, and parental guidance are essential tools in this process. By supporting optimal growth and development, pediatricians play a vital role in ensuring children reach their full potential both physically and mentally. Early detection and holistic care are crucial for lifelong health.

GROWTH AND DEVELOPMENT

Growth and Development

Growth and development are key indicators of a child's overall health and well-being. For pediatricians, monitoring these aspects involves assessing physical milestones such as height, weight, and head circumference, as well as developmental progress in motor skills, language, cognition, and social interaction. Regular check-ups help identify any delays or concerns early, allowing for timely interventions. Growth charts, developmental screenings, and parental guidance are essential tools in this process. By supporting optimal growth and development, pediatricians play a vital role in ensuring children reach their full potential both physically and mentally. Early detection and holistic care are crucial for lifelong health.

PAEDIATRIC PAIN MEDICINE SPECIALIST

Paediatric Pain Medicine Specialist
A Paediatric Pain Medicine Specialist provides comprehensive care for children experiencing acute, chronic, or complex pain conditions. These specialists assess, diagnose, and treat pain caused by injury, surgery, illness, or developmental disorders. They employ a multidisciplinary approach, including medication management, physical therapy, psychological support, and advanced interventions like nerve blocks or neuromodulation. Education and support for families are integral, ensuring understanding and effective pain management strategies. Working closely with pediatricians, surgeons, and other healthcare providers, they aim to improve the child’s quality of life, enhance functional abilities, and reduce the emotional and physical impact of pain.

INTERVENTIONAL PAIN MANAGEMENT

Interventional Pain Management
Interventional pain management provides targeted treatments to alleviate chronic or acute pain, improve function, and enhance the quality of life. It employs minimally invasive techniques tailored to each patient’s specific condition. Key services include: Epidural Steroid Injections: Relieve inflammation and pain caused by herniated discs, spinal stenosis, or sciatica. Nerve Blocks: Target specific nerves to reduce pain and inflammation in areas like the neck, back, or limbs. Radiofrequency Ablation (RFA): Uses heat to disrupt nerve signals responsible for chronic pain. Spinal Cord Stimulation: Implants a device to modify pain signals before they reach the brain. Joint Injections: Treat pain in knees, hips, shoulders, and other joints. Trigger Point Injections: Alleviate pain in muscle knots or spasms.

SPINAL PAIN MANAGEMENT

Spinal Pain Management
Spinal pain management focuses on diagnosing and treating conditions that cause back, neck, and spinal pain. These services typically include a comprehensive evaluation to identify the source of pain, followed by tailored treatments to improve function and quality of life. Common interventions include physical therapy to strengthen muscles and improve mobility, medication management for pain relief, and minimally invasive procedures such as epidural steroid injections, nerve blocks, and radiofrequency ablation to target pain at its source. Advanced treatments like spinal cord stimulation and regenerative therapies, including platelet-rich plasma (PRP) and stem cell therapy, are also offered in some cases. Patient education on ergonomics, posture, and lifestyle modifications is integral to long-term pain management. With a multidisciplinary approach, spinal pain management services aim to reduce pain, restore mobility, and help patients regain their daily routines.

SKIN DISEASES

Skin Diseases


Skin diseases encompass a wide range of conditions that affect the skin, resulting in various symptoms and appearances. Some common skin diseases include:

  1. Acne: A common skin condition characterized by the formation of pimples, blackheads, and whiteheads on the face, chest, and back.
  2. Eczema: A chronic inflammatory condition that causes dry, itchy, and red patches on the skin.
  3. Psoriasis: A chronic autoimmune disease that causes red, scaly patches on the skin, often accompanied by itching or pain.
  4. Dermatitis: Inflammation of the skin that can be caused by various factors such as irritants, allergens, or genetic predisposition.
  5. Rosacea: A chronic skin condition characterized by facial redness, flushing, and sometimes pimples or visible blood vessels.
  6. Hives (Urticaria): Raised, itchy bumps on the skin that are often caused by an allergic reaction or exposure to certain triggers.
  7. Athlete's Foot: A fungal infection that affects the feet, causing itching, redness, and peeling of the skin.
  8. Ringworm: A fungal infection that forms a ring-shaped rash on the skin, often itchy and scaly.
  9. Impetigo: A highly contagious bacterial infection characterized by red sores that break open, ooze, and form a yellowish crust.
  10. Shingles: A viral infection caused by the reactivation of the varicella-zoster virus, resulting in a painful rash with fluid-filled blisters.

It's important to consult a dermatologist or healthcare professional for an accurate diagnosis and appropriate treatment for any skin condition.

CHILDHOOD DISEASES

Childhood Diseases

Childhood diseases refer to a wide range of illnesses that primarily affect children. Some common childhood diseases include:

  1. Chickenpox (Varicella): A highly contagious viral infection causing an itchy rash and fever.
  2. Measles: A viral infection characterized by fever, cough, runny nose, and a rash.
  3. Mumps: A viral infection causing swelling and pain in the salivary glands, leading to swollen cheeks and jaw.
  4. Rubella (German Measles): A viral infection causing a rash and fever, particularly dangerous for pregnant women.
  5. Whooping cough (Pertussis): A bacterial infection causing severe coughing spells, especially dangerous for infants.
  6. Hand, Foot, and Mouth Disease: A viral infection characterized by sores in the mouth, on the hands, and on the feet.
  7. Rotavirus: A highly contagious virus causing severe diarrhea, vomiting, and dehydration in infants and young children.
  8. Fifth Disease (Erythema infectiosum): A viral infection causing a distinctive rash on the face, cheeks, and body.
  9. Croup: A viral infection causing a barking cough and difficulty breathing.
  10. Roseola: A viral infection characterized by high fever followed by a rash.

It's important to note that diagnosing and treating specific diseases should be done by medical professionals. If you have concerns about a child's health, it's best to consult a healthcare provider.



WOMAN DISEASES

Woman Diseases

"Woman Disease" is a broad term that does not refer to a specific medical condition. Women can be affected by a variety of diseases and health conditions, some of which are unique to or more common in females. It's essential to address specific diseases or conditions to provide accurate information.

Here are some common health conditions that can affect women:

  1. Breast Cancer: A malignant tumor that develops in breast tissue, predominantly affecting women.
  2. Ovarian Cancer: Cancer that begins in the ovaries, the female reproductive organs responsible for producing eggs.
  3. Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, causing pain and fertility problems.
  4. Polycystic Ovary Syndrome (PCOS): A hormonal disorder characterized by enlarged ovaries with cysts and hormonal imbalances, leading to irregular periods and other symptoms.
  5. Cervical Cancer: Cancer that develops in the cervix, the lower part of the uterus.
  6. Premenstrual Syndrome (PMS): A combination of physical and emotional symptoms that occur in the days leading up to menstruation.
  7. Urinary Tract Infections (UTIs): Infections in the urinary system, including the bladder and urethra, which can be more common in women.
  8. Osteoporosis: A condition characterized by a decrease in bone density, making bones more fragile and prone to fractures, which is more common in women, especially after menopause.
  9. Menopause: The natural process that occurs in women's lives, typically in their 40s or 50s when menstrual periods cease and hormone levels change.
  10. Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs, usually caused by sexually transmitted bacteria.

It's important to note that these are just a few examples, and there are many more health conditions that can affect women. If you have concerns about your health, it's recommended to consult a healthcare professional for a proper diagnosis and treatment.

HYPNOTICS

Hypnotics

used to induce and maintain sleep.

ANTIPSYCHOTIC MEDICATIONS

Antipsychotic medications

used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder.

ANTIDEPRESSANTS

Antidepressants

used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders.

VACCINATION AND CHECK-UP

Vaccination And Check-up
Regular health checks can detect any early warning signs of illness. During a health check-up, our doctors will inquire about your medical history, family history of the disease, and your lifestyle, which includes your diet, weight, physical activity, alcohol consumption, and smoking habits. Kidney and liver function, blood tests, glucose levels, chest x-ray, ECG, abdomen ultrasound, and urine analysis are among the tests done. Everyone should have a routine checkup once a year, however, if you have an underlying health problem, you should see a doctor more frequently. We use a multidisciplinary team approach to prevent, detect, and treat a variety of illnesses, including diabetes, hypertension, obesity, cardiac issues, and cancer. Our team of preventive health experts encourages you to adopt healthy lifestyle habits and provides customized solutions to help you maintain your health and improve your quality of life. Services like immunization are also offered at our clinic. It is a process that protects people from harmful infections and illnesses before they become infected. Vaccines are used to provide immunity. Some of these include - the pneumococcal vaccine, an annual flu shot, a tetanus-diphtheria-pertussis booster, a herpes zoster vaccine, and vaccines for conditions like Measles, Mumps, Hepatitis, and more.

INFECTIOUS DISEASES

Infectious Diseases
A microbiome of bacteria, pathogens, fungi, and viruses lives in your body. They usually do not cause any harm. Microorganisms, on the other hand, can occasionally cause disease. Infection-causing pathogens or parasites can also be contracted from other people, animals, insects, or contaminated food. Infectious diseases can be difficult to diagnose and treat because their symptoms and severity vary so much. Experts specialize in the diagnosis and treatment of a wide range of these conditions. Depending on your condition and symptoms, appropriate diagnostic methods are performed to identify the root cause and on the basis of that treatment is provided. If you experience symptoms like unexplained high fever, flu, common cold, or sepsis, be cautious.

GASTRIC DISORDERS

Gastric Disorders
Gastrointestinal conditions are disorders of the digestive system, an extensive and complex system that breaks down food in order to absorb water and extract nutrients, minerals, and vitamins for the body's use, while also removing unabsorbed waste (feces). The symptoms of digestive disorders differ from one condition to the other and from one person to the other. However, some common symptoms include: Abdominal discomfort (bloating, pain or cramps) Unintentional weight loss Nausea and vomiting Acid reflux (heartburn) Constipation and diarrhea Fecal incontinence Fatigue Appetite loss Difficulty swallowing If you notice blood in your vomit or stool, contact your doctor right away.

PAIN MANAGEMENT

Pain Management
Pain or chronic pain is a complete medical problem that has a significant impact on your immune system and can result in unexpected outcomes. We provide comprehensive pain management services for a wide range of chronic pain conditions, including back pain, neck pain, shoulder pain, facial pain, headache, neuropathic pain, slipped disc, failed back surgery pain, sciatica, and others. At our pain management clinic, you will receive the best pain treatment available. For our patients. we offer the most advanced pain treatment options available anywhere in the world. We care for our patients in a supportive and compassionate environment, allowing them to regain their independence and comfort while improving their quality of life. We guarantee a pain-free life in order to improve the overall quality of life.

MIGRAINE

Migraine
Migraine is characterized by throbbing pain on one side of the head. A migraine headache is triggered by a variety of factors, including stress, hormonal imbalance, and others. It may be accompanied by vomiting, nausea, eye pain, or light sensitivity in some cases. Migraine attacks cause excruciating headaches that can last for hours or even days. The cause of a migraine is unknown; however, it is linked to unusual brain activity. The unusual changes in the brain have an impact on the normal functioning of the nervous system and result in a chemical imbalance in the brain. The following are the primary migraine triggers: Stress Hormonal imbalance Diet Physical ailments Medications Environmental triggers Furthermore, there is no single treatment that can completely eliminate migraines. The majority of available treatments are aimed at alleviating symptoms and preventing migraine attacks from occurring in the first place.

RESPIRATORY PROBLEMS

Respiratory Problems
Respiratory illness is a common problem in metropolitan cities. Certain factors and behaviours, such as smoking, air pollution, and environmental issues can contribute to respiratory diseases. Other causes include autoimmune diseases such as rheumatoid arthritis and genetic defects. Asthma, chronic obstructive pulmonary disease, cystic fibrosis, chronic bronchitis, tuberculosis, lung cancer, pulmonary edema, and pneumonia are examples of common respiratory diseases. Early symptoms of respiratory diseases include wheezing, difficulty breathing, chest pain, chronic cough with or without blood, and excessive mucus production. These symptoms are warning signs that necessitate immediate medical attention, so consulting a doctor is strongly advised.

HEART PROBLEMS

Heart Problems
High blood pressure is usually caused by the narrowing of the arteries caused by the buildup of a sticky substance called plaque. Plaque forms as a result of excess cholesterol in your blood, which is typically caused by a diet high in certain types of fats and low in fibre. As plaque accumulates along the artery walls, the arteries become less flexible and less capable of efficiently transporting blood. This is referred to as artery "hardening." High blood pressure can also be caused by smoking, obesity or being overweight, excessive drinking or other substance abuse, and being physically inactive. Blood pressure is also more common in the elderly. Various medications can be used to keep blood pressure under control. Quitting smoking, reducing unhealthy fats, and consuming more fibre along with regular exercise are all important lifestyle changes. It's critical to have your blood pressure checked on a regular basis to ensure that your treatment is working. High blood pressure usually causes no symptoms until serious damage occurs, thus making regular checkups all the more important.

HEART PROBLEMS

Heart Problems
Despite having a chronic cardiac condition, you can live a healthy, happy life if you have the right team in place, the right medications and devices prescribed as needed, and the right lifestyle changes. A chronic cardiac condition is usually caused by a diseased or damaged heart. Some common problems are: Coronary artery disease (CAD) Heart attack High blood pressure Valve disease Cardiomyopathy A chronic cardiac condition's symptoms can range from mild to severe and vary from person to person. Symptoms can appear suddenly or gradually, depending on the cause. A very mild condition may not have any visible symptoms at all. It is critical to recognize the signs as soon as they appear and to treat the condition as soon as possible with the assistance of your cardiac healthcare team. Treatment differs from one patient to the next.

THYROID DISEASE

Thyroid Disease
The thyroid gland, which is located at the base of the neck, is in charge of releasing hormones into the bloodstream. This gland's malfunction can result in a variety of symptoms and complications. The highly experienced specialists at our clinic help diagnose and treat patients with thyroid disorders. Thyroid disease occurs when the thyroid gland produces either too much or too little hormones. Thyroid diseases include hyperthyroidism, hypothyroidism, thyroiditis, and Hashimoto's thyroiditis. We provide comprehensive, seamless, coordinated, and patient-centered care by keeping patients at the center of our program. From the initial evaluation to treatment and meticulous follow-up monitoring, we use a team approach to coordinate all aspects of patient care. Look no further and schedule a thyroid examination if you are facing any fertility issues, weight issues, or are seeing any recent bodily changes such as excessive sweating, hand tremors, or sleep problems.

DIABETES MANAGEMENT

Diabetes Management
We specialize in helping patients manage their diabetes so they can stay healthy. Diabetes mellitus is a metabolic disorder characterized by high levels of blood glucose (blood sugar). Diabetes causes high blood sugar levels because the body does not produce enough insulin (the hormone that converts nutrients into energy), or because the cells do not respond to the insulin that is produced. Diabetes, if left undiagnosed and untreated, can lead to cardiovascular disease, kidney damage, stroke, amputations due to diabetic foot conditions, and blindness due to diabetic retinopathy. We have the knowledge and experience to accurately diagnose and effectively manage diabetes at our clinic. Our diabetes specialists assess and care for people with all types of diabetes and diabetes-related issues. Furthermore, our Diabetes Management Program provides comprehensive diabetes education to patients and families.

GROWTH AND NUTRITION

Growth And Nutrition
Good nutrition is required for the proper growth and development of children. To obtain good nutrition it is highly essential to eat a healthy balanced diet. A balanced diet is one that has all the nutrients like carbohydrates, proteins, and fats in the right proportion. Children's need for nutrition and energy is greatly higher than other age groups. It is estimated that undernourished children have less energy and so it has a negative impact on their academic performance. The nutrients needed for growth and development are protein, calcium, vitamins, omega-3 fats, iodine, and Zinc. Good hair growth symbolizes good nutrition. The nutrients required for good hair growth are vitamin C, biotin, iron, and zinc. Foods that help you to maintain your height are lean meat, chicken, beans, almonds, eggs, and leafy green vegetables. Good nutrition during childhood helps the children develop immunity against infections, ensures the good development of the brain and other organs, and improves the child's cognitive functioning. Poor nutrition can lead to nutritional deficiencies which in turn leads to deficiency disorders and has a great impact on their growth and development.

INFANT CARE

Infant Care
The infant is a term that indicates the age group of 0 to 1 year. It is the time period during which there is Rapid growth in both mental and physical spheres. There are some basic essential needs that are common to all infants including warmth and affection, good nourishment, and prevention of infection. Newborn cord care is a very important thing to take care of. Always the stump should be kept dry and it is advisable to stick with a sponge bath rather than a wet bath. The newborn cord usually takes around two weeks to heal. A newborn is so delicate that the skin has to be given extra care. The baby's skin has to be kept hydrated by bathing them in warm water for three to five minutes. Application of good baby lotion or moisturizer after bath is very essential. Remember to always pt the skin dry rather than rubbing. Newborn care is essential to avoid infections and minimize the risk of illness since the immune system of the newborn is weak. Proper knowledge is essential before starting with newborn care and you can acquire this knowledge from our experienced physicians. We provide prenatally and post-natal counseling so that your journey is comfortable and stress-free.

INFECTIOUS DISEASES

Infectious Diseases
Infections are more common in children than in other age groups due to the weaker and developing immune systems in children. They are in close contact with other children in the classrooms, transport, and Day Care Centres. It is due to this reason that infections are more likely to occur in children than adults. The most common infectious diseases during childhood are common cold, ear infections, conjunctivitis, gastroenteritis, and diseases of the hand, foot, and mouth. Infections are caused by a wide range of microorganisms which may be bacteria, viruses, or fungi. Skin infections are more common in children since they are exposed to a lot of microorganisms in the ground and transmission from other children through touch. Since it is the period during which they learn toilet training habits, it is easier for them to acquire urinary tract(UTI) infections. The main cause of UTI infection in children is E Coli bacteria. The treatment includes the administration of antibiotics either orally or through IV. Depending upon the type of infection, antiviral and antifungal medications are also given. It is important to diagnose the infection at the earliest and provide appropriate treatment to avoid complications. Do remember that infections can be varied and timely diagnosis and care are of utmost importance.

VACCINATION AND CHECKUP

Vaccination And Checkup
Vaccination is the simple and safest way to protect ourselves from infections. Vaccination is the process of administering a vaccine that helps the immune system to acquire immunity against a specific disease or infection. Vaccines contain microorganisms either in the live or killed state, which when administered develop immunity. When a large number of people get vaccinated, it results in herd immunity. Vaccination is found to be greatly responsible for the eradication of smallpox, and for the elimination of tetanus and polio from most parts of the world. It is important to vaccinate your child in order to give them a healthy future. For the pediatric age group, there is a list of vaccines to be administered according to the schedule including BCG, MMR, and so on. It is essential that you do not skip your children’s vaccination as a primary prevention measure. Vaccinations keep us healthy from infectious microorganisms and thereby boost our immunity and hence greatly prevent them from future disabilities and infections.

SORE THROAT

Sore Throat
Sore throats are common in children and can be painful. However, a sore throat that is caused by a virus does not need antibiotics. In those cases, no specific medicine is required, and your child should get better in seven to ten days. In other cases, a sore throat could be caused by an infection called streptococcal (strep throat). Strep cannot be accurately diagnosed by simply looking at the throat. A lab test or in-office rapid strep test, which includes a quick swab of the throat, is necessary to confirm the diagnosis of strep. If positive for strep, your pediatrician will prescribe an antibiotic. It's very important that your child take the antibiotic for the full course, as prescribed, even if the symptoms get better or go away. Steroid medicines (such as prednisone) are not an appropriate treatment for most cases of sore throat. Babies and toddlers rarely get it strep throat, but they are more likely to become infected by streptococcus bacteria if they are in child care or if an older sibling has the illness. Although strep spreads mainly through coughs and sneezes, your child can also get it by touching a toy that an infected child has played with.

FAQs

What if my query is not listed here?
If you have any more queries that aren't listed, you can email us or call us.
Why is it best to consult a specialist?
A specialist doctor is trained to treat complex health conditions in their particular field. If you are diagnosed with a condition, it is best to consult a doctor who specializes in dealing with that particular condition.
Why should I consult Dr Rakesh Khandel?
Dr Rakesh Khandel is a specialist in Pediatrics and having more than 10 years of experience.
What if my query is not listed here?
If you have any more queries that aren't listed, you can email us.
Why is it best to consult a specialist?
A specialist doctor is trained to treat complex health conditions in their particular field. If you are diagnosed with a condition, it is best to consult a doctor who specializes in dealing with that particular condition.
How can I book an appointment?
You can click on the book appointment link.
Do I need to bring anything at my first appointment?
You may bring the following documents, if available: ID Proof Prior medication list Any prior diagnosis documentation X-RAY reports