Add Patient | Dreams EMR - Responsive Bootstrap 5 Medical Admin Template

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John Doe

added new patient appointment booking.

4 min ago

Thomas William

booked a new appointment

8 min ago

Sarah Anderson

has been successfully booked for April 5 at 10:00 AM.

15 min ago

Ann McClure

cancelled her appointment scheduled for February 5, 2024

20 min ago

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Jimmy Anderson

Administrator

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Multi Level
- Multilevel 1
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  - Multilevel 2.1
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Patients

Home
Add Patient

Back to Patient

Basic Information

Profile Image*

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ID

First Name*

Middle Name*

Last Name*

Blood Group*

Select

dropdown with 7 options

Age*

DOB*

Patient Type*

Select

dropdown with 3 options

Gender*

Select

dropdown with 4 options

Company Name with Location

Martial Status*

Select

dropdown with 3 options

Contact Information

Mobile Number*

Emergency Number*

Guardian / Person Name*

Address Line 1*

Address Line 2

Country*

Select

dropdown with 6 options

City

Select

dropdown with 5 options

State

Select

dropdown with 6 options

Pincode

Referral Doctor’s Info

Referred By*

Select

dropdown with 11 options

Referred On*

Department*

Select

dropdown with 10 options

Other Information

Notes If Any

Vitals

Temperature*

F

Pulse*

mmHg

Respiratory Rate*

rpm

SPO2*

%

Height*

cm

Weight*

Kg

BMI*

kg/cm

Waist*

cm

BSA*

M

Quick Notes

Medical History

Type

Select

dropdown with 3 options

Reason

Date of Illness

Hospital Name

Assessment done if any

Notes

Type

Select

dropdown with 3 options

Reason

Date of Illness

Hospital Name

Assessment done if any

Notes

Add More

Complaints

Patients Overall Health Condition

Select

dropdown with 5 options

Does patient have any health Condition

Allergies if Any Before

Save & Confirm

Added Successfully

Patient “Hendrita Merkel” has been added to the Patient List

Back To List View Details

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