DM    X15 
HTN   15
IHD     5  C  CATH  LAST NE  BEFORE   3  YEARS 
DLD

CHF  with ef  45
sever diastolic dysfunction 
av  mv  mildc  dilated 
creatinine
CKD    with base line creatinine 


creatinine  4


medication 
sulprime  
aldactone 
slow   k  2x2 
hydralazin  50 mg 1x1
feerrous  1x1 
asa   100 mg once
vascor  20 1x2
lasix  2x2
concor 5 mg once
clovix 75 mg once
insulin    apidra  20  am and  20 pm 