you ought to have a table of patients and store the patient id in tblPatientProc (patient procedures) as a minimum. Maybe a table for procedure options, depending on your needs (provides a list of procedures to be selected, eliminating keying errors). Not sure where Diagnoses fits in but probably should be its own table as well in the same way as procedure options. Then you'd need junction tables to relate patients to procedures and one for diagnoses. I suppose more info about how these relate to one another would be required to be more specific and accurate. The main take away, I think, is that your current table design resembles a spreadsheet (wide format where columns are additional data points) whereas a db is "tall" (tables hold additional data points as records; AKA "rows" but not really). I'd start with examining why any of this would be dependent upon Excel as a data source going forward. This is a job for a db and Excel should be eliminated as the data source.
The more we hear silence, the more we begin to think about our value in this universe.
Paraphrase of Professor Brian Cox.