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Patient Registration, '*' Means This Field Is Required - Coggle…
Patient Registration
Patient Information
*
Title
*Date of Birth
Meladi
Hijeri
*Name
*First
*Middle
*Family
Grand Father Name
*Age
VIP
Marital Status
UHID
*National ID
*Passport No.
*Nationality ID
Language
Arabic
English
*Gender
Doctor
*Religion
DR. Availability Button
Upload Photo
Upload ID Card
Scan
Address Details
Next of Kin(Emergncy Contact)
*Relation to Patient
*Mobile No.
*Contact Name
Present Address
State
County
*City
Phone No.
Area
*Mobile
*Address
Email
*Nationality
'*' Means This Field Is Required