Doctor Portal

Add New Patient Record

Enter the patient's details. This information will be added to the central clinic records.

Patient Identification

Full Name

Email Address

Contact & Demographics

Phone Number (Optional)

Date of Birth (Optional)

Age (Optional)

Medical Overview

General Medical Notes (Optional)

Specific Medical Conditions

Please check all that apply:

Diabetes

High Blood Pressure

History of Stroke/Heart Attack

Bleeding Disorders

Allergy

Asthma/Respiratory Issues

Supporting Documents

Upload X-ray Images or PDFs (Optional)

Drag & drop or click to select files.