diff --git a/IRaCIS.Core.Application/Service/Visit/PatientService.cs b/IRaCIS.Core.Application/Service/Visit/PatientService.cs
index 0989156d6..1367fe3c5 100644
--- a/IRaCIS.Core.Application/Service/Visit/PatientService.cs
+++ b/IRaCIS.Core.Application/Service/Visit/PatientService.cs
@@ -7,7 +7,6 @@ using Microsoft.AspNetCore.Authorization;
 using IRaCIS.Core.Application.Auth;
 using MassTransit;
 using Panda.DynamicWebApi.Attributes;
-using DocumentFormat.OpenXml.Spreadsheet;
 using AutoMapper.EntityFrameworkCore;
 using IRaCIS.Core.Domain.Models;
 using IRaCIS.Core.Application.Service.Reading.Dto;
@@ -24,32 +23,27 @@ using Medallion.Threading;
 using IRaCIS.Core.Infrastructure;
 using IRaCIS.Core.Application.Contracts;
 using MailKit.Search;
-using DocumentFormat.OpenXml.Office2010.Excel;
 using IRaCIS.Core.Application.Contracts.Dicom.DTO;
 using IRaCIS.Core.Application.Helper;
 using System.Linq;
 using System.Linq.Dynamic.Core;
 using System.Text;
-using DocumentFormat.OpenXml.EMMA;
 using Azure;
 using System.IO.Compression;
 using static IRaCIS.Core.Domain.Share.StaticData;
 using FellowOakDicom;
 using IDistributedLockProvider = Medallion.Threading.IDistributedLockProvider;
-using DocumentFormat.OpenXml.InkML;
 using Microsoft.AspNetCore.Hosting;
 using IRaCIS.Core.Infrastructure.Encryption;
 using FellowOakDicom.Network.Client;
 using FellowOakDicom.Network;
 using Microsoft.Extensions.Logging;
-using DocumentFormat.OpenXml.Wordprocessing;
 using System;
 using IRaCIS.Core.Infra.EFCore.Migrations;
 using System.Dynamic;
 using System.Threading.Channels;
 using IRaCIS.Core.Application.Helper.OtherTool;
 using IRaCIS.Core.Infrastructure.Extention;
-using NPOI.SS.Formula.Functions;
 
 
 namespace IRaCIS.Application.Services