Patient Registration · Cloudify Eye Care

Fix the highlighted fields to create the patient record.

Patient Details

Basic information to open the patient’s folder.

Clinic Patient ID

Out Patient ID

Title (optional)

First Name *

First Name must have some value.

Last Name *

Last Name must have some value.

Date Of Birth

Type or pick a date (DD/MM/YYYY). Age

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Calculated from Date Of Birth.

Gender *

Gender must have some value.

Contact *

Contact must have some value.

Alternative Contact

Deliver SMS ?

Create a booking for today at the same time.

Assign Doctor

Booking Type

Patient Type

Referral Type

ID Type

ID Number

Emergency Contact Person

Emergency Contact

Address Religion

Occupation

Country

Nationality