23    years old male pt 
free  past medical  hx 
family hx  negative 

one month history for   generalized weakness and     fatigue 
headache   band  like  headache 
low  sight   vision   last   time  he  sought ophthalmologist 
no chest pain 
cough and sob 

no abdominal pain 
no diarrgea   conspation 
smoker   didnot change his  smoke cigaret 

no dysuria  or oligouria 

plan 
add   basilox   400 mg once daily 
pikta      syrpus    10 mg once 