Doctor Profiling

BO/BE Name: ABM Name: No____________ General profile

Dr Name: Dr Code

Age: _______________________ Gender: Male/ Female General Practice: 1. How many years have you been actively practicing? (a)____ 0 to 3 (b) ____ 3 to 5 (c) ____ 5 to 8 (d) ____ 8 to 10 (e) ____ > 10 2. How many diabetic patients do you see on a daily basis? (a)____ 0 to 5 (b) ____ 5 to 10 (c) ____ 11 to 15 (d) ____ 15 to 25 (b) Kindly tick the corresponding option and specify the number of patients. ______ 3. How many cardiovascular patients do you see on a daily basis? (a)____ 0 to 5 (b) ____ 5 to 10 (c) ____ 11 to 15 (d) ____ 15 to 25 (b) Kindly tick the corresponding option and specify the number of patients. ______ 4. Of the diabetic patient (as mentioned in Q.No. 2) what no of patients are newly diagnosed diabetes patients? (a)____ 0 to 5 (b) ____ 5 to 10 (c) ____ 11 to 15 (d) ____ 15 to 25 (b) Kindly tick the corresponding option and specify the number of patients. ______ 5. What is the average time period between two visits for a diabetic patient? (a) One month (b) Two months (c) Three months (d) More than three months 6. What is the average time period between two visits for a cardiovascular patient? (a) One month (b) Two months (c) Three months (d) More than three months 7. Of the total patients (as mentioned in Q.No. 2) how many patients are prescribed AGI? (a)____ 0 to 10% (b) ____ 11 to 30% (c) ____ 31 to 50% (d) ____ 51 to 75% (e)____ 75to 100% 8. Of the total patients who are prescribed AGI therapy, how many are prescribed Acarbose? (a)____ 0 to 10% (b) ____ 11 to 30% (c) ____ 31 to 50% (d) ____ 51 to 75% (e)____ 75to 100%

For BPPL