Registration of Patients (Patient Registration Form)
a. Age as per Year/Months/days
b. Entry Date
c. Entry time
d. Patient Urgency(Emergency, normal,Priority)
e. County Of birth
f. County of residence
g. Place of birth
h. From referred Facility(Combo Box)
i. Referred County(Combo Box)
j. Employer
k. Employer phone number
l. Name of chief
m. Name of constituency
n. Name of sub chief
o. Patient type (New/Revisit)
p. Patient with Disability(y/n)
NB:
I. No patient should be saved twice
II. Patient Number to be displayed upon saving patient
III. PATIENT REGISTERED SUCCESSFULLY) Upon clicking save button
IV. Change the form format as agreed before
Registration of Patients (Patient Registration Form) a. Age as per Year/Months/days b. Entry Date c. Entry time d. Patient Urgency(Emergency, normal,Priority) e. County Of birth f. County of residence g. Place of birth h. From referred Facility(Combo Box) i. Referred County(Combo Box) j. Employer k. Employer phone number l. Name of chief m. Name of constituency n. Name of sub chief o. Patient type (New/Revisit) p. Patient with Disability(y/n) NB: I. No patient should be saved twice II. Patient Number to be displayed upon saving patient III. PATIENT REGISTERED SUCCESSFULLY) Upon clicking save button IV. Change the form format as agreed before