HIS
Developed by Acorn Research
Dashboard
Patients
Appointments
Lab Tests
Reports
3
Patient Registration
Personal Information
Basic patient details and identification
First Name (English) *
Last Name (English) *
Full Name (Arabic)
Civil ID *
Date of Birth *
Pick a date
Gender *
Male
Female
Nationality
Contact Information
Phone, email, and address details
Phone Number *
Email Address
Emergency Contact Name
Emergency Contact Phone
Address
Governorate
Select governorate
Insurance Information
Health insurance and coverage details
Insurance Provider
Select insurance provider
Insurance Number
Medical Information
Health history and medical details
Blood Type
Select blood type
Known Allergies
Chronic Conditions
Current Medications
Consent & Agreements
Required consents and agreements
I consent to medical treatment and procedures as deemed necessary by healthcare providers
I consent to sharing my medical data with authorized healthcare providers within the network
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Register Patient