A realistic doctor's handwritten prescription on a standard Indian OPD prescription pad. The prescription is for a patient named Mrs Bharathi Pandarinath Patil, female. Date: 16/07/2026. Hospital: ACPMMMC. The handwriting is in blue ink, slightly hurried but legible, typical of a real doctor. The prescription contains: At top: Rx symbol Diagnosis written small: Ureteric colic (Lt), Adhesive capsulitis (Rt shoulder), T2DM Medications listed as: 1. Tab. Diclofenac + Paracetamol (50mg+325mg) 1 tab TID x 5 days (after food) 2. Tab. Pantoprazole 40mg 1 tab OD before breakfast x 5 days 3. Tab. Tamsulosin 0.4mg 1 tab OD at night x 2 weeks 4. Tab. Metformin 500mg 1 tab BD with meals (continue) 5. Cap. Methylcobalamin 500mcg 1 cap OD x 1 month 6. Syrup. Cystone 2 tsp BD x 4 weeks Investigations below: - USG KUB - Urine R/M - S. Creatinine, Blood Urea - FBS / PPBS / HbA1c - X-ray Rt. Shoulder AP + Lateral Advice section: - Plenty of oral fluids (3L/day) - Avoid spicy/oily food - Physiotherapy for Rt shoulder - Follow up after 1 week / review with reports At bottom: Doctor's signature scrawl, with text "Dr. [signature]" and "MBBS, MD" under it. The paper is white/off-white, slightly aged, with faint printed lines. Real prescription pad feel with a faint hospital letterhead at top. Blue ink pen writing throughout.

A realistic Indian doctor handwritten OPD prescription on white prescription paper. Blue ink pen, slightly hurried cursive medical handwriting, authentic and natural looking. Top section has printed hospital header: ACPMMMC, Aavdhan | OPD Reg No: 1182392 | Date: 16/07/2026 | Patient: Mrs Bharathi Pandarinath Patil | Age/Sex: 52y / F | Dept: Surgery Large Rx symbol on left side. Diagnosis (small, underlined): Ureteric colic (Lt) | Adhesive capsulitis (Rt shoulder) | T2DM on treatment Handwritten medications in numbered list: 1. Tab. Diclofenac + Paracetamol 50/325mg - 1-0-1 x 5 days (after food) 2. Tab. Pantoprazole 40mg - 1-0-0 (before BF) x 5 days 3. Tab. Tamsulosin 0.4mg - 0-0-1 x 14 days 4. Tab. Metformin 500mg - 1-0-1 (with meals) - continue 5. Cap. Methylcobalamin 500mcg - 0-0-1 x 30 days 6. Syr. Cystone 2 tsp BD x 4 weeks Investigations (handwritten, underlined heading): USG KUB + Urine R/M + S. Creatinine + FBS/HbA1c + X-ray Rt shoulder AP view Advice (handwritten): Oral fluids 3L/day. Avoid spicy food. Physio for Rt shoulder. F/U after 1 wk with reports. Bottom right: doctor signature scrawl + Dr. __ MBBS MD stamp box

mkdir -p /tmp/workspace/prescription && python3 << 'EOF' from PIL import Image, ImageDraw, ImageFont import random, math, os # Canvas: A5 size at 150dpi ~ 874x1240 W, H = 874, 1240 img = Image.new("RGB", (W, H), (255, 253, 248)) draw = ImageDraw.Draw(img) # ── helpers ────────────────────────────────────────────────────────────────── def jitter(x, y, a=1, b=1): return x + random.uniform(-a, a), y + random.uniform(-b, b) def get_font(size, bold=False): candidates = [ "/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf" if bold else "/usr/share/fonts/truetype/dejavu/DejaVuSans.ttf", "/usr/share/fonts/truetype/liberation/LiberationSans-Bold.ttf" if bold else "/usr/share/fonts/truetype/liberation/LiberationSans-Regular.ttf", ] for c in candidates: if os.path.exists(c): return ImageFont.truetype(c, size) return ImageFont.load_default() def draw_text(x, y, text, size=16, bold=False, color=(20, 20, 120), jit=0): if jit: x, y = jitter(x, y, jit, jit//2) font = get_font(size, bold) draw.text((x, y), text, font=font, fill=color) def hline(y, x0=40, x1=834, color=(180,180,200), width=1): draw.line([(x0, y), (x1, y)], fill=color, width=width) # ── faint ruled lines ───────────────────────────────────────────────────────── for yi in range(80, H, 28): hline(yi, color=(210, 215, 225), width=1) # ── border ─────────────────────────────────────────────────────────────────── draw.rectangle([(18, 18), (W-18, H-18)], outline=(100, 130, 180), width=2) draw.rectangle([(22, 22), (W-22, H-22)], outline=(160, 180, 210), width=1) # ── HEADER ─────────────────────────────────────────────────────────────────── draw_text(W//2 - 200, 28, "ACPMMMC | Aavdhan, Pune", size=17, bold=True, color=(30, 50, 130)) draw_text(W//2 - 130, 50, "OPD Case Paper", size=13, color=(80, 80, 140)) hline(70, color=(100, 130, 180), width=2) # Patient info row draw_text(38, 78, "Reg. No: ACPMMMC/1182392", size=13, bold=False, color=(40,40,40)) draw_text(370, 78, "Date: 16/07/2026", size=13, bold=False, color=(40,40,40)) draw_text(38, 96, "Patient: Mrs Bharathi Pandarinath Patil", size=14, bold=True, color=(10,10,80)) draw_text(38, 116, "Age/Sex: 52 yrs / F", size=13, color=(40,40,40)) draw_text(320, 116,"Dept: General Surgery", size=13, color=(40,40,40)) hline(136, color=(100,130,180), width=2) # ── Dx ─────────────────────────────────────────────────────────────────────── draw_text(38, 144, "Dx:", size=15, bold=True, color=(160, 0, 0)) draw_text(78, 144, "Ureteric colic (Lt) | Adhesive capsulitis (Rt shoulder) | T2DM on Rx", size=14, color=(160,0,0)) hline(164, color=(160,160,180)) # ── Big Rx symbol ───────────────────────────────────────────────────────────── rx_font = get_font(56, bold=True) draw.text((28, 170), "℞", font=rx_font, fill=(30, 50, 130)) # ── Medications ────────────────────────────────────────────────────────────── meds = [ ("1.", "Tab. Diclofenac + Paracetamol", "50 mg + 325 mg", "1-0-1 × 5 days (after food, avoid empty stomach)"), ("2.", "Tab. Pantoprazole", "40 mg", "1-0-0 (before breakfast) × 5 days"), ("3.", "Tab. Tamsulosin", "0.4 mg", "0-0-1 (at bedtime) × 14 days"), ("4.", "Tab. Metformin 500 mg", "", "1-0-1 with meals — CONTINUE"), ("5.", "Cap. Methylcobalamin", "500 mcg", "0-0-1 × 30 days"), ("6.", "Syr. Cystone", "2 tsp (10 mL)", "BD × 4 weeks (after meals)"), ] y = 180 for num, drug, dose, sig in meds: y += 38 draw_text(52+random.uniform(-1,1), y+random.uniform(-1,1), num, size=15, bold=True, color=(20,20,100)) draw_text(78+random.uniform(-1,1), y+random.uniform(-1,1), drug, size=15, bold=True, color=(10,10,80)) if dose: draw_text(78+random.uniform(-1,1), y+18+random.uniform(-1,1), f" {dose}", size=13, color=(60,60,60)) draw_text(78+random.uniform(-1,1), y+33+random.uniform(-1,1), f" Sig: {sig}", size=13, color=(50,80,50)) y += 28 # ── Investigations ──────────────────────────────────────────────────────────── y += 18 hline(y, color=(100,130,180), width=1) y += 8 draw_text(38, y, "Investigations:", size=15, bold=True, color=(0,90,0)) invs = [ "1. USG Abdomen + KUB (for calculus, hydronephrosis)", "2. Urine Routine & Microscopy (R/M)", "3. S. Creatinine, Blood Urea, S. Electrolytes", "4. FBS | PPBS | HbA1c", "5. X-ray Rt. Shoulder AP + Lateral view", "6. CBC with ESR", ] for inv in invs: y += 26 draw_text(52+random.uniform(-1,1), y+random.uniform(-1,1), inv, size=13, color=(20,80,20)) # ── Advice ──────────────────────────────────────────────────────────────────── y += 20 hline(y, color=(100,130,180), width=1) y += 8 draw_text(38, y, "Advice:", size=15, bold=True, color=(100, 50, 0)) advices = [ "★ Oral fluids 3 – 3.5 L per day (helps flush calculus)", "★ Avoid spicy, oily food; reduce salt intake", "★ Do NOT self-stop Metformin; monitor blood sugar daily", "★ Physiotherapy for Rt. shoulder (pendulum + ROM exercises)", "★ Return IMMEDIATELY if: fever, chills, no urine, severe pain", "★ Follow-up: 1 week with all investigation reports", ] for adv in advices: y += 24 draw_text(52+random.uniform(-1,1), y+random.uniform(-1,1), adv, size=13, color=(120, 60, 0)) # ── Signature area ──────────────────────────────────────────────────────────── y += 36 hline(y, color=(160,160,180)) draw_text(560, y+10, "Dr. [Signature]", size=16, bold=True, color=(20,20,100)) draw_text(560, y+32, "MBBS, MD (General Medicine)", size=12, color=(60,60,100)) draw_text(560, y+50, "ACPMMMC, Aavdhan", size=12, color=(60,60,100)) draw_text(560, y+68, "Regn. No: MH-XXXXX", size=11, color=(100,100,130)) # ── slight paper texture ────────────────────────────────────────────────────── import numpy as np arr = np.array(img).astype(np.int16) noise = np.random.randint(-4, 5, arr.shape, dtype=np.int16) arr = np.clip(arr + noise, 0, 255).astype(np.uint8) img = Image.fromarray(arr) out = "/tmp/workspace/prescription/Rx_Bharathi_Patil_16Jul2026.png" img.save(out, dpi=(150,150)) print("Saved:", out) EOF