mkdir -p /home/daytona/workspace/oncology-discharge && ls /home/daytona/workspac…

~/oncology-discharge/generate_discharge.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import mm, cm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether
)
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_RIGHT, TA_JUSTIFY
from reportlab.platypus import BaseDocTemplate, PageTemplate, Frame
from reportlab.lib.colors import HexColor

OUTPUT_PATH = "/home/daytona/workspace/oncology-discharge/Oncology_Discharge_Summary.pdf"

# ── Colour palette ──────────────────────────────────────────────────────────
DEEP_BLUE   = HexColor("#1A3A5C")   # headers / title bar
MID_BLUE    = HexColor("#2E6DA4")   # section headings
LIGHT_BLUE  = HexColor("#D6E8F7")   # table header row background
ORANGE      = HexColor("#E07B39")   # accent line under hospital name
LIGHT_GREY  = HexColor("#F5F5F5")   # alternating table row bg
RED_ALERT   = HexColor("#C0392B")   # allergy / alert text
WHITE       = colors.white
BLACK       = colors.black

W, H = A4

# ── Document setup ──────────────────────────────────────────────────────────
doc = BaseDocTemplate(
    OUTPUT_PATH,
    pagesize=A4,
    leftMargin=18*mm, rightMargin=18*mm,
    topMargin=22*mm, bottomMargin=20*mm,
    title="Medical Oncology Discharge Summary – Supportive Care",
    author="Tata Cancer Care Centre, Mumbai",
)

content_width = W - 36*mm   # usable width

frame = Frame(
    doc.leftMargin, doc.bottomMargin,
    content_width, H - doc.topMargin - doc.bottomMargin,
    id='normal'
)

def header_footer(canvas, doc_obj):
    canvas.saveState()
    # Top rule
    canvas.setStrokeColor(MID_BLUE)
    canvas.setLineWidth(0.8)
    canvas.line(18*mm, H - 14*mm, W - 18*mm, H - 14*mm)
    # Footer
    canvas.setFont("Helvetica", 7)
    canvas.setFillColor(colors.grey)
    canvas.drawString(18*mm, 12*mm, "CONFIDENTIAL – For treating physician use only")
    canvas.drawRightString(W - 18*mm, 12*mm, f"Page {doc_obj.page}")
    canvas.line(18*mm, 14*mm, W - 18*mm, 14*mm)
    canvas.restoreState()

doc.addPageTemplates([PageTemplate(id='main', frames=[frame], onPage=header_footer)])

# ── Styles ───────────────────────────────────────────────────────────────────
base = getSampleStyleSheet()

def s(name, **kw):
    p = ParagraphStyle(name, parent=base['Normal'], **kw)
    return p

HOSPITAL = s("hospital", fontSize=16, fontName="Helvetica-Bold",
             textColor=WHITE, alignment=TA_CENTER, spaceAfter=0)
HOSP_SUB = s("hsub", fontSize=8.5, fontName="Helvetica",
             textColor=HexColor("#BDD9F2"), alignment=TA_CENTER, spaceAfter=0)
DOC_TITLE = s("docTitle", fontSize=13, fontName="Helvetica-Bold",
              textColor=DEEP_BLUE, alignment=TA_CENTER, spaceAfter=4)
SEC_HEAD  = s("secHead", fontSize=10, fontName="Helvetica-Bold",
              textColor=WHITE, alignment=TA_LEFT,
              leftIndent=4, spaceAfter=0, spaceBefore=8)
LABEL     = s("label", fontSize=8.5, fontName="Helvetica-Bold",
              textColor=DEEP_BLUE, spaceAfter=1)
VALUE     = s("value", fontSize=9, fontName="Helvetica",
              textColor=BLACK, spaceAfter=2)
SMALL     = s("small", fontSize=8, fontName="Helvetica",
              textColor=colors.grey)
ALERT     = s("alert", fontSize=9, fontName="Helvetica-Bold",
              textColor=RED_ALERT)
BODY      = s("body", fontSize=9, fontName="Helvetica",
              textColor=BLACK, leading=13, spaceAfter=3,
              alignment=TA_JUSTIFY)
BULLET    = s("bullet", fontSize=9, fontName="Helvetica",
              textColor=BLACK, leading=12, leftIndent=10, bulletIndent=0,
              spaceAfter=2)
SIG_STYLE = s("sig", fontSize=8.5, fontName="Helvetica",
              textColor=colors.grey, alignment=TA_CENTER)

def section_header(text):
    """Returns a full-width coloured banner for a section."""
    tbl = Table([[Paragraph(text, SEC_HEAD)]], colWidths=[content_width])
    tbl.setStyle(TableStyle([
        ('BACKGROUND', (0,0), (-1,-1), MID_BLUE),
        ('TOPPADDING',  (0,0), (-1,-1), 4),
        ('BOTTOMPADDING', (0,0), (-1,-1), 4),
        ('LEFTPADDING',  (0,0), (-1,-1), 6),
    ]))
    return tbl

def kv_table(rows, col_ratios=(0.30, 0.70)):
    """Two-column label-value table."""
    cw = [content_width * r for r in col_ratios]
    data = [[Paragraph(lbl, LABEL), Paragraph(val, VALUE)] for lbl, val in rows]
    tbl = Table(data, colWidths=cw)
    tbl.setStyle(TableStyle([
        ('VALIGN', (0,0), (-1,-1), 'TOP'),
        ('TOPPADDING', (0,0), (-1,-1), 3),
        ('BOTTOMPADDING', (0,0), (-1,-1), 3),
        ('LEFTPADDING', (0,0), (-1,-1), 4),
        ('ROWBACKGROUNDS', (0,0), (-1,-1), [WHITE, LIGHT_GREY]),
        ('LINEBELOW', (0,-1), (-1,-1), 0.3, colors.lightgrey),
    ]))
    return tbl

def three_col_table(rows, headers, ratios=(0.35, 0.35, 0.30)):
    cw = [content_width * r for r in ratios]
    head_row = [Paragraph(f"<b>{h}</b>", s("th", fontSize=8.5, fontName="Helvetica-Bold",
                           textColor=DEEP_BLUE)) for h in headers]
    data = [head_row]
    for row in rows:
        data.append([Paragraph(cell, VALUE) for cell in row])
    tbl = Table(data, colWidths=cw)
    tbl.setStyle(TableStyle([
        ('BACKGROUND', (0,0), (-1,0), LIGHT_BLUE),
        ('ROWBACKGROUNDS', (0,1), (-1,-1), [WHITE, LIGHT_GREY]),
        ('VALIGN', (0,0), (-1,-1), 'TOP'),
        ('TOPPADDING', (0,0), (-1,-1), 3),
        ('BOTTOMPADDING', (0,0), (-1,-1), 3),
        ('LEFTPADDING', (0,0), (-1,-1), 4),
        ('GRID', (0,0), (-1,-1), 0.3, colors.lightgrey),
    ]))
    return tbl

def four_col_table(rows, headers, ratios=(0.22, 0.22, 0.28, 0.28)):
    cw = [content_width * r for r in ratios]
    head_row = [Paragraph(f"<b>{h}</b>", s("th4", fontSize=8.5, fontName="Helvetica-Bold",
                           textColor=DEEP_BLUE)) for h in headers]
    data = [head_row]
    for row in rows:
        data.append([Paragraph(cell, VALUE) for cell in row])
    tbl = Table(data, colWidths=cw)
    tbl.setStyle(TableStyle([
        ('BACKGROUND', (0,0), (-1,0), LIGHT_BLUE),
        ('ROWBACKGROUNDS', (0,1), (-1,-1), [WHITE, LIGHT_GREY]),
        ('VALIGN', (0,0), (-1,-1), 'TOP'),
        ('TOPPADDING', (0,0), (-1,-1), 3),
        ('BOTTOMPADDING', (0,0), (-1,-1), 3),
        ('LEFTPADDING', (0,0), (-1,-1), 4),
        ('GRID', (0,0), (-1,-1), 0.3, colors.lightgrey),
    ]))
    return tbl

# ═══════════════════════════════════════════════════════════════════════════
# BUILD STORY
# ═══════════════════════════════════════════════════════════════════════════
story = []

# ── Hospital Header Banner ───────────────────────────────────────────────────
hosp_banner = Table(
    [[Paragraph("TATA CANCER CARE CENTRE", HOSPITAL)],
     [Paragraph("Department of Medical Oncology | Supportive & Palliative Care Unit", HOSP_SUB)],
     [Paragraph("Mumbai – 400 012, Maharashtra | Tel: 022-6750-0000 | www.tatacancercare.org", HOSP_SUB)]],
    colWidths=[content_width]
)
hosp_banner.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,-1), DEEP_BLUE),
    ('TOPPADDING',  (0,0), (-1,-1), 5),
    ('BOTTOMPADDING', (0,-1), (-1,-1), 8),
    ('LEFTPADDING',  (0,0), (-1,-1), 4),
]))
story.append(hosp_banner)
story.append(HRFlowable(width=content_width, thickness=3, color=ORANGE, spaceAfter=6))

# Document title
story.append(Paragraph("MEDICAL ONCOLOGY DISCHARGE SUMMARY", DOC_TITLE))
story.append(Paragraph("(Supportive Care Admission)", s("subT", fontSize=9.5,
             fontName="Helvetica-Oblique", textColor=MID_BLUE, alignment=TA_CENTER)))
story.append(Spacer(1, 6))

# ── SECTION 1: Patient Demographics ─────────────────────────────────────────
story.append(section_header("1.  PATIENT DEMOGRAPHICS"))
story.append(Spacer(1, 3))

# Top row: two side-by-side mini tables
left_kv = [
    ("Patient Name:", "Smt. Sunita Ramesh Patil"),
    ("Age / Sex / Blood Group:", "52 Years / Female / B+ve"),
    ("Date of Birth:", "14 March 1974"),
    ("Marital Status:", "Married"),
    ("Religion:", "Hindu"),
    ("Address:", "Flat No. 7, Shivaji Nagar, Pune – 411 005"),
    ("Contact Number:", "+91 98765 43210"),
    ("Guardian / Attendant:", "Shri Ramesh Patil (Husband) – +91 98765 43211"),
    ("Referred By:", "Dr. P. K. Nair, MBBS MD – Nair Hospital, Pune"),
    ("UHID / MRD No.:", "TATA-ONC-2026-04872"),
]
right_kv = [
    ("Admission Date:", "30 June 2026"),
    ("Discharge Date:", "09 July 2026"),
    ("Total Days Admitted:", "10 Days"),
    ("Ward / Bed:", "Oncology Ward – Bed No. 14B"),
    ("Treating Consultant:", "Dr. Anjali Mehta, MD DM Medical Oncology"),
    ("Co-consultant:", "Dr. Suresh Kadam, MD Palliative Medicine"),
    ("Resident / JR:", "Dr. Priya Soni (Junior Resident)"),
    ("Nursing In-charge:", "Nurse Kavita Joshi"),
    ("Insurance / Ayushman:", "Ayushman Bharat PMJAY – Policy No. 0045-2026"),
    ("ECOG Performance Status:", "2 (at admission) → 1 (at discharge)"),
]
demo_left  = kv_table(left_kv,  (0.40, 0.60))
demo_right = kv_table(right_kv, (0.44, 0.56))
demo_outer = Table([[demo_left, Spacer(4,1), demo_right]],
                   colWidths=[content_width*0.49, 4, content_width*0.49])
demo_outer.setStyle(TableStyle([('VALIGN', (0,0), (-1,-1), 'TOP')]))
story.append(demo_outer)
story.append(Spacer(1, 6))

# ── SECTION 2: Oncological Diagnosis ────────────────────────────────────────
story.append(section_header("2.  ONCOLOGICAL DIAGNOSIS"))
story.append(Spacer(1, 3))
story.append(kv_table([
    ("Primary Diagnosis:", "Carcinoma Left Breast – Invasive Ductal Carcinoma (IDC), Grade III"),
    ("Stage:", "Stage IIIB (T4b N2 M0) – Locally Advanced Breast Cancer"),
    ("Receptor Status:", "ER +ve (80%), PR +ve (60%), HER2 2+ (FISH Non-amplified) – Luminal B (HER2-negative)"),
    ("Date of Histopathology:", "12 April 2026  |  Biopsy Lab Ref: TATA-PATH-2026-1122"),
    ("Ki-67 Index:", "35% (High Proliferative)"),
    ("Date of Initial Diagnosis:", "10 April 2026"),
    ("Comorbidities:", "Type 2 Diabetes Mellitus (on OHA), Hypertension (controlled), Iron-Deficiency Anaemia"),
    ("Known Allergies:", "<font color='#C0392B'><b>ALLERGIC TO PENICILLIN (Rash) – Documented on armband</b></font>"),
], (0.30, 0.70)))
story.append(Spacer(1, 6))

# ── SECTION 3: Current Admission – Reason ───────────────────────────────────
story.append(section_header("3.  REASON FOR THIS ADMISSION"))
story.append(Spacer(1, 3))
story.append(Paragraph(
    "Patient was admitted with <b>Grade 3 febrile neutropaenia</b> following Cycle 3 of neoadjuvant "
    "chemotherapy (AC-T regimen: Doxorubicin + Cyclophosphamide). She presented with high-grade fever "
    "(39.8°C), rigors, oral mucositis (WHO Grade II), nausea/vomiting (CTCAE Grade 2), and significant "
    "fatigue. She also had worsening oral intake with body weight loss of 3 kg over 3 weeks, raising "
    "concern for nutritional compromise. Admission was also prompted by uncontrolled pain (NRS 7/10) "
    "from bone metastasis-related back pain.", BODY))
story.append(Spacer(1, 6))

# ── SECTION 4: Treatment Given During Admission ───────────────────────────────
story.append(section_header("4.  TREATMENT ADMINISTERED DURING ADMISSION"))
story.append(Spacer(1, 3))

story.append(Paragraph("<b>A. Anti-infective / Neutropaenia Management</b>", LABEL))
story.append(Spacer(1,2))
story.append(four_col_table([
    ["Inj. Piperacillin-Tazobactam 4.5 g IV Q8H", "30 Jun – 06 Jul 2026", "7 days", "Empiric broad-spectrum; de-escalated on culture sensitivity"],
    ["Inj. Amikacin 15 mg/kg IV OD", "30 Jun – 03 Jul 2026", "4 days", "Gram-negative cover; stopped on Day 4 (culture guided)"],
    ["Inj. Fluconazole 400 mg IV OD", "30 Jun – 05 Jul 2026", "6 days", "Antifungal prophylaxis; switched to oral on Day 6"],
    ["Inj. Filgrastim 300 mcg SC OD", "01 Jul – 06 Jul 2026", "6 days", "G-CSF – neutropaenia recovery"],
    ["Inj. Acyclovir 5 mg/kg IV Q8H", "01 Jul – 04 Jul 2026", "4 days", "HSV prophylaxis in immunocompromised state"],
], ["Drug / Dose / Route / Frequency", "Duration", "No. of Days", "Remarks"],
   ratios=(0.35, 0.22, 0.12, 0.31)))
story.append(Spacer(1, 4))

story.append(Paragraph("<b>B. Supportive Care – Antiemetics, Pain &amp; Nutrition</b>", LABEL))
story.append(Spacer(1,2))
story.append(four_col_table([
    ["Inj. Ondansetron 8 mg IV TID", "30 Jun – 08 Jul", "9 days", "5-HT3 antagonist; nausea control"],
    ["Tab. Metoclopramide 10 mg TID (PO) – after Day 5", "05 Jul – 08 Jul", "4 days", "Prokinetic; gastric stasis"],
    ["Inj. Pantoprazole 40 mg IV OD", "30 Jun – 09 Jul", "10 days", "Gastroprotection"],
    ["Tab. Pantoprazole 40 mg PO OD at discharge", "Discharge Rx", "Continue", "Step-down oral PPI"],
    ["Inj. Tramadol 50 mg IV Q8H (PRN)", "30 Jun – 03 Jul", "4 days", "Moderate-severe pain (NRS 7/10)"],
    ["Tab. Oxycodone CR 10 mg PO Q12H", "04 Jul onwards", "Continue", "Opioid rotation – better pain control"],
    ["Tab. Pregabalin 75 mg BD", "02 Jul onwards", "Continue", "Neuropathic component"],
    ["Tab. Paracetamol 500 mg TID (PRN)", "30 Jun onwards", "Continue", "Adjuvant analgesic / antipyretic"],
    ["Ryle's Tube feeding: Ensure Plus 200 mL Q4H", "01 Jul – 05 Jul", "5 days", "Enteral nutrition support – poor oral intake"],
    ["High-protein oral nutritional supplement (Protinex)", "06 Jul onwards", "Continue", "Oral sip feeds – 2 servings/day"],
    ["IV Fluids: NS 0.9% + KCl 20 mEq @ 80 mL/hr", "30 Jun – 04 Jul", "5 days", "Hydration, electrolyte correction"],
    ["Inj. Iron Sucrose 200 mg IV in 100 mL NS", "02, 04, 06 Jul", "3 doses", "Iron deficiency anaemia (Hb 7.8 on admission)"],
    ["PRBC transfusion 2 units", "03 July 2026", "1 session", "Hb 7.2 g/dL; symptomatic anaemia"],
], ["Drug / Intervention", "Duration", "Days", "Remarks"],
   ratios=(0.33, 0.17, 0.10, 0.40)))
story.append(Spacer(1, 4))

story.append(Paragraph("<b>C. Oral Care / Mucositis Management</b>", LABEL))
story.append(Spacer(1,2))
story.append(three_col_table([
    ["Magic Mouthwash (Lignocaine + Antacid + Diphenhydramine) 10 mL QID swish-spit", "07 days", "WHO Grade II Mucositis"],
    ["Benzydamine HCl 0.15% mouthwash TID", "07 days", "Anti-inflammatory rinse"],
    ["Clotrimazole oral lozenges 10 mg 5 x/day", "05 days", "Oral candidiasis prevention"],
    ["Soft / liquid diet; calorie-dense foods advised", "Ongoing", "Dietitian reviewed on Day 3"],
], ["Intervention", "Duration", "Reason / Notes"],
   ratios=(0.45, 0.15, 0.40)))
story.append(Spacer(1, 4))

story.append(Paragraph("<b>D. Psycho-Social &amp; Palliative Care Input</b>", LABEL))
story.append(Spacer(1,2))
story.append(three_col_table([
    ["Palliative care team review", "Day 2 &amp; Day 8", "Goals-of-care discussion; advance care planning initiated"],
    ["Psychiatric / Counselling referral", "Day 4", "Moderate anxiety-depression (PHQ-9 score 14); initiated Tab. Escitalopram 10 mg OD"],
    ["Social worker assessment", "Day 5", "Ayushman Bharat reimbursement facilitated; home nursing arranged"],
    ["Patient &amp; caregiver education (verbal + printed pamphlet in Marathi)", "Day 8 &amp; 9", "Chemotherapy side-effects, infection precautions, diet, pain diary"],
], ["Intervention", "Timing", "Details"],
   ratios=(0.28, 0.18, 0.54)))
story.append(Spacer(1, 6))

# ── SECTION 5: Investigations ────────────────────────────────────────────────
story.append(section_header("5.  KEY INVESTIGATIONS"))
story.append(Spacer(1, 3))

story.append(Paragraph("<b>Haematology &amp; Biochemistry (Admission vs Discharge)</b>", LABEL))
story.append(Spacer(1,2))
story.append(four_col_table([
    ["Haemoglobin (g/dL)",       "7.2",   "10.4",  "Post 2U PRBC transfusion + Iron sucrose"],
    ["Total WBC (cells/µL)",     "380",   "4,200", "Nadir on Day 1; recovery with G-CSF"],
    ["ANC (cells/µL)",           "80",    "2,800", "Severe neutropaenia → resolved"],
    ["Platelets (lakh/µL)",      "0.9",   "1.4",   "Mild thrombocytopenia; recovered spontaneously"],
    ["Serum Creatinine (mg/dL)", "1.1",   "0.9",   "Within normal limits"],
    ["Serum Sodium (mEq/L)",     "131",   "138",   "Mild hyponatraemia corrected"],
    ["Serum Potassium (mEq/L)",  "3.1",   "3.9",   "Hypokalaemia corrected with supplementation"],
    ["ALT / SGPT (U/L)",         "68",    "34",    "Mild transaminitis; resolved"],
    ["Serum Albumin (g/dL)",     "2.6",   "2.9",   "Improving with nutritional support"],
    ["Blood Sugar Fasting (mg/dL)","178", "112",   "Glycaemic control improved; OHA adjusted"],
    ["Blood Culture (Day 1)",    "E. coli (ESBL negative, sensitive to Pip-Taz)", "—", "Guided antibiotic therapy"],
    ["CXR (01 Jul 2026)",        "No consolidation; small left pleural effusion", "—", "Stable at discharge"],
    ["ECHO (03 Jul 2026)",       "EF 58%; no regional wall motion abnormality", "—", "Baseline pre-anthracycline"],
], ["Parameter", "At Admission", "At Discharge", "Remarks"],
   ratios=(0.30, 0.18, 0.18, 0.34)))
story.append(Spacer(1, 6))

# ── SECTION 6: Summary of Hospital Course ────────────────────────────────────
story.append(section_header("6.  SUMMARY OF HOSPITAL COURSE"))
story.append(Spacer(1, 3))
story.append(Paragraph(
    "Patient was admitted with post-chemotherapy febrile neutropaenia (Grade 3) after Cycle 3 "
    "of AC chemotherapy. She was started promptly on empiric broad-spectrum IV antibiotics "
    "(Piperacillin-Tazobactam + Amikacin) as per institutional febrile neutropaenia protocol "
    "(MASCC Score 17 – Low Risk; admitted as per patient preference and logistic considerations). "
    "Blood culture grew E. coli, sensitive to the empiric regimen. Antibiotics were continued for a "
    "total of 7 days and successfully de-escalated. G-CSF (Filgrastim) was administered for 6 days; "
    "ANC recovered to &gt;2,000 by Day 7.", BODY))
story.append(Paragraph(
    "Symptomatic anaemia (Hb 7.2 g/dL) was managed with 2 units of packed red blood cells and "
    "3 doses of IV iron sucrose. Nutritional status was supported initially via nasogastric enteral feeds "
    "(5 days) and transitioned to oral sip feeds with dietitian supervision. Body weight improved by "
    "1.2 kg over the admission.", BODY))
story.append(Paragraph(
    "Pain was initially controlled with IV tramadol and was effectively rotated to oral sustained-release "
    "oxycodone with addition of pregabalin for the neuropathic component; NRS score improved from 7/10 "
    "to 2/10 at discharge. Oral mucositis healed to Grade I by Day 8. Electrolyte imbalances (hyponatraemia, "
    "hypokalaemia) were corrected. Blood sugar was stabilised with dose adjustment of oral hypoglycaemics. "
    "Palliative care and psychiatry teams were involved for goals-of-care planning and management of "
    "anxiety-depression. Patient and caregivers were educated in Marathi and English; home nursing "
    "services were arranged via the social worker.", BODY))
story.append(Spacer(1, 4))

# ── SECTION 7: Condition at Discharge ────────────────────────────────────────
story.append(section_header("7.  CONDITION AT DISCHARGE"))
story.append(Spacer(1, 3))
story.append(kv_table([
    ("General Condition:", "Stable, afebrile (Temp 37.1°C), ambulatory"),
    ("ECOG Performance Status:", "1 (improved from 2 at admission)"),
    ("Vital Signs at Discharge:", "BP 128/80 mmHg | PR 82/min, regular | SpO₂ 98% (RA) | RR 16/min"),
    ("Pain (NRS):", "2/10 – well-controlled on oral opioid regimen"),
    ("Oral Intake:", "Tolerating soft diet + high-protein sip feeds"),
    ("Emotional Status:", "Improved; less anxious; engaged with counselling"),
    ("Caregiver Status:", "Husband present; educated and capable of home care"),
], (0.28, 0.72)))
story.append(Spacer(1, 6))

# ── SECTION 8: Discharge Medications ─────────────────────────────────────────
story.append(section_header("8.  DISCHARGE MEDICATIONS (Rx)"))
story.append(Spacer(1, 3))
story.append(Paragraph(
    "<font color='#C0392B'><b>ALLERGY: PENICILLIN</b></font>  –  ensure no beta-lactam penicillins are prescribed in the community.",
    ALERT))
story.append(Spacer(1, 3))
story.append(four_col_table([
    ["Tab. Oxycodone CR (OxyContin) 10 mg", "Twice daily (every 12 hrs)", "14 days", "Opioid – for persistent cancer pain; do NOT crush"],
    ["Tab. Paracetamol 500 mg", "Three times daily (TID)", "14 days", "Adjuvant analgesic / breakthrough pain"],
    ["Tab. Pregabalin 75 mg", "Twice daily (BD)", "14 days", "Neuropathic pain"],
    ["Tab. Pantoprazole 40 mg", "Once daily (before breakfast)", "30 days", "Gastroprotection with NSAIDs/steroids"],
    ["Tab. Ondansetron 4 mg", "Twice daily (PRN for nausea)", "10 days", "As-needed antiemetic"],
    ["Tab. Metoclopramide 10 mg", "Three times daily (before meals)", "10 days", "Prokinetic – nausea/gastric stasis"],
    ["Tab. Escitalopram 10 mg", "Once daily (morning)", "30 days", "Anxio-depressive symptoms; psychiatry follow-up"],
    ["Cap. Fluconazole 150 mg", "Once weekly", "4 weeks", "Antifungal maintenance; immunosuppressed state"],
    ["Tab. Acyclovir 400 mg", "Twice daily", "14 days", "HSV prophylaxis"],
    ["Tab. Cotrimoxazole DS", "Once daily (Mon/Wed/Fri)", "Until ANC &gt;500 sustained", "PCP prophylaxis (CD4 equivalent status)"],
    ["Tab. Metformin 500 mg + Glimepiride 1 mg", "Twice daily (with meals)", "Continue", "Diabetes management; BSFL 112 at discharge"],
    ["Tab. Amlodipine 5 mg", "Once daily (morning)", "Continue", "Antihypertensive"],
    ["Protinex (high-protein supplement) – 2 scoops", "Twice daily in warm milk/water", "Continue", "Nutritional support – target 1.5 g protein/kg/day"],
    ["Iron (Ferrous Ascorbate) 100 mg", "Twice daily (on empty stomach)", "30 days", "Iron deficiency anaemia – ongoing course"],
    ["Tab. Folic Acid 5 mg", "Once daily", "30 days", "Megaloblastic prevention with chemotherapy"],
], ["Drug / Formulation", "Dose / Frequency", "Duration", "Special Instructions"],
   ratios=(0.32, 0.22, 0.18, 0.28)))
story.append(Spacer(1, 4))
story.append(Paragraph(
    "<b>Note:</b> All opioid prescriptions have been issued with Schedule X narcotic prescription slips "
    "(as per NDPS Act India). Caregiver has been counselled on safe opioid storage, "
    "constipation prophylaxis, and signs of opioid toxicity.", SMALL))
story.append(Spacer(1, 6))

# ── SECTION 9: Dietary & Lifestyle Advice ─────────────────────────────────────
story.append(section_header("9.  DIETARY &amp; LIFESTYLE ADVICE (Advised by Dietitian Ms. Rekha More)"))
story.append(Spacer(1, 3))
bullets = [
    "Target caloric intake: <b>2,000–2,200 kcal/day</b>; protein target: <b>75–80 g/day</b> (1.5 g/kg/day).",
    "Foods encouraged: Soft-cooked lentils (dal), curd/yoghurt, mashed potato, soft idli/upma, boiled eggs, fish curry, ragi porridge, banana, papaya, seasonal fruits (washed thoroughly).",
    "Foods to <b>AVOID</b> during chemotherapy: Raw salads, uncooked sprouts, street food (chaat, pani puri), unpasteurised milk/cheese (paneer from street vendors), high-fibre raw vegetables, alcohol, tobacco products.",
    "Maintain oral hygiene: Rinse after every meal with warm saline or prescribed mouthwash.",
    "Adequate hydration: Minimum <b>2–2.5 litres/day</b> of boiled/filtered water.",
    "Light physical activity as tolerated: 15–20-minute walks twice daily (if ANC &gt;1,000).",
    "Avoid crowded places, religious gatherings, sick contacts – infection precautions during neutropaenia phase.",
    "Report any fever ≥38°C immediately to oncology emergency (do not wait – come directly to casualty).",
]
for b in bullets:
    story.append(Paragraph(f"• {b}", BULLET))
story.append(Spacer(1, 6))

# ── SECTION 10: Follow-up Plan ────────────────────────────────────────────────
story.append(section_header("10.  FOLLOW-UP PLAN"))
story.append(Spacer(1, 3))
story.append(three_col_table([
    ["<b>CBC + Blood Sugar + LFT + KFT</b>", "14 July 2026 (Day 5 post-discharge)", "Community lab OR TATA OPD Lab; report to bring on follow-up"],
    ["<b>Medical Oncology OPD – Dr. Anjali Mehta</b>", "16 July 2026 – 10:00 AM (OPD No. 14)", "Pre-Cycle 4 evaluation; dose modification if needed"],
    ["<b>Palliative Medicine – Dr. Suresh Kadam</b>", "18 July 2026", "Pain assessment; opioid dose titration"],
    ["<b>Psychiatry OPD</b>", "20 July 2026", "Escitalopram response evaluation; counselling continuation"],
    ["<b>Dietitian Review</b>", "23 July 2026 (telephonic)", "Nutritional status, weight trend, sip feed compliance"],
    ["<b>Cycle 4 Chemotherapy (Paclitaxel 175 mg/m²)</b>", "28 July 2026 (tentative)", "Subject to ANC &gt;1,500, Hb &gt;9, Platelets &gt;1,00,000"],
], ["Appointment", "Date / Time", "Details"],
   ratios=(0.32, 0.28, 0.40)))
story.append(Spacer(1, 6))

# ── SECTION 11: Emergency Instructions ───────────────────────────────────────
story.append(section_header("11.  EMERGENCY INSTRUCTIONS – WHEN TO COME TO HOSPITAL IMMEDIATELY"))
story.append(Spacer(1, 3))
alert_items = [
    "Fever ≥38°C or chills/rigors at any time (do <b>NOT</b> give paracetamol and wait – come directly)",
    "Bleeding from any site (gums, nose, urine, stool, skin bruising)",
    "Sudden breathlessness, chest pain, or palpitations",
    "Severe pain (NRS &gt;6) not responding to prescribed medications",
    "Inability to take oral medications or severe vomiting for &gt;12 hours",
    "Confusion, altered sensorium, fits or severe headache",
    "Swelling, redness, or pus at the IV cannula site or PICC line",
    "Signs of opioid overdose: excessive drowsiness, slow breathing (&lt;8/min), pinpoint pupils",
]
for item in alert_items:
    story.append(Paragraph(f"⚠  {item}", s("alertBullet", fontSize=9, fontName="Helvetica",
                 textColor=HexColor("#7B2D00"), leading=13, leftIndent=8, spaceAfter=2)))
story.append(Spacer(1, 3))
story.append(Paragraph(
    "<b>Oncology Emergency Helpline (24×7):</b>  022-6750-0911  |  "
    "<b>Oncology Casualty:</b>  Ground Floor, Block C, TATA Cancer Care Centre, Mumbai",
    s("emHelpline", fontSize=9, fontName="Helvetica-Bold", textColor=DEEP_BLUE)))
story.append(Spacer(1, 6))

# ── SECTION 12: Signatures ────────────────────────────────────────────────────
story.append(section_header("12.  SIGNATURES &amp; CERTIFICATION"))
story.append(Spacer(1, 6))

sig_data = [
    [
        Paragraph("<b>Dr. Anjali Mehta</b><br/>MD, DM Medical Oncology<br/>"
                  "Reg. No.: MCI-2003-DM-04891<br/>Date: 09 July 2026", SIG_STYLE),
        Paragraph("<b>Dr. Suresh Kadam</b><br/>MD Palliative Medicine<br/>"
                  "Reg. No.: MCI-2007-MD-11223<br/>Date: 09 July 2026", SIG_STYLE),
        Paragraph("<b>Dr. Priya Soni</b><br/>MBBS, Junior Resident<br/>"
                  "Reg. No.: MMC-2022-01567<br/>Date: 09 July 2026", SIG_STYLE),
        Paragraph("<b>Nurse Kavita Joshi</b><br/>B.Sc Nursing, Oncology Certified<br/>"
                  "Staff ID: TATA-NRS-442<br/>Date: 09 July 2026", SIG_STYLE),
    ]
]
sig_labels = [
    Paragraph("____________________________", SIG_STYLE),
    Paragraph("____________________________", SIG_STYLE),
    Paragraph("____________________________", SIG_STYLE),
    Paragraph("____________________________", SIG_STYLE),
]

sig_tbl = Table(
    [sig_labels, sig_data[0]],
    colWidths=[content_width/4]*4
)
sig_tbl.setStyle(TableStyle([
    ('VALIGN', (0,0), (-1,-1), 'BOTTOM'),
    ('TOPPADDING', (0,0), (-1,-1), 2),
    ('BOTTOMPADDING', (0,0), (-1,-1), 2),
    ('ALIGN', (0,0), (-1,-1), 'CENTER'),
]))
story.append(sig_tbl)
story.append(Spacer(1, 8))

# Patient acknowledgement
ack_tbl = Table([[
    Paragraph(
        "Patient / Guardian Acknowledgement:<br/>"
        "I, <u>Shri Ramesh Patil</u>, have received and understood the discharge instructions, "
        "medication list, and follow-up plan in <b>Marathi and English</b>.<br/><br/>"
        "Signature: ____________________________  &nbsp;&nbsp;&nbsp;"
        "Date: 09 July 2026 &nbsp;&nbsp;&nbsp; Relation to Patient: Husband",
        s("ack", fontSize=8.5, fontName="Helvetica", textColor=BLACK, leading=13))
]], colWidths=[content_width])
ack_tbl.setStyle(TableStyle([
    ('BOX', (0,0), (-1,-1), 0.8, MID_BLUE),
    ('BACKGROUND', (0,0), (-1,-1), LIGHT_BLUE),
    ('TOPPADDING', (0,0), (-1,-1), 6),
    ('BOTTOMPADDING', (0,0), (-1,-1), 6),
    ('LEFTPADDING', (0,0), (-1,-1), 8),
]))
story.append(ack_tbl)
story.append(Spacer(1, 6))

# ── Footer disclaimer ─────────────────────────────────────────────────────────
story.append(HRFlowable(width=content_width, thickness=0.5, color=colors.grey))
story.append(Spacer(1, 3))
story.append(Paragraph(
    "This discharge summary is generated for clinical and documentation purposes. "
    "Details are fictitious and created for demonstration / training. "
    "All drug dosages and regimens should be verified against current institutional guidelines "
    "and the prescribing physician's clinical judgment. "
    "Orris Medical AI – July 2026.",
    s("disclaimer", fontSize=7, fontName="Helvetica-Oblique",
      textColor=colors.grey, alignment=TA_CENTER)))

# ═══════════════════════════════════════════════════════════════════════════
# BUILD
# ═══════════════════════════════════════════════════════════════════════════
doc.build(story)
print(f"PDF saved to: {OUTPUT_PATH}")

cd /home/daytona/workspace/oncology-discharge && python generate_discharge.py 2>…

~/oncology-discharge/generate_discharge.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/oncology-discharge/generate_discharge.py'

~/oncology-discharge/generate_discharge.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/oncology-discharge/generate_discharge.py'

~/oncology-discharge/generate_discharge.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/oncology-discharge/generate_discharge.py'

~/oncology-discharge/generate_discharge.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/oncology-discharge/generate_discharge.py'

~/oncology-discharge/generate_discharge.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/oncology-discharge/generate_discharge.py'

cd /home/daytona/workspace/oncology-discharge && python generate_discharge.py 2>…

cd /home/daytona/workspace/oncology-discharge && python -c " from reportlab.lib.…

cd /home/daytona/workspace/oncology-discharge && python -c " import traceback ex…

~/oncology-discharge/generate_discharge.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/oncology-discharge/generate_discharge.py'

~/oncology-discharge/generate_discharge.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/oncology-discharge/generate_discharge.py'

cd /home/daytona/workspace/oncology-discharge && python generate_discharge.py 2>…

ASCO guideline palliative care cancer

ASCO 2024 2025 palliative care oncology guideline update

PMID: 38748941

PMID: 36469839

PMID: 36122322

https://ascopubs.org/doi/10.1200/JCO.24.00542

PMID: 40029420