Patient ID
This item is required, however, can be generated automatically by the sytem. Maximum of 64 characters
allowed.
Last Name
Enter the last name of the patient.
First Name
Enter the first name of the patient.
DOB
Enter the date of birth of the patient. Only numerical value is allowed. The age of the patient will be calculated
automatically.
Sex
Enter the gender of the patient.
Accession#
Maximum of 64 characters allowed.
Weight(kg)
Enter the weight of the patient in kilograms. Only numerical value is allowed.
Height(cm)
Enter the height of patient in centimeters. Only numerical value is allowed.
BSA(m
)
Select Eastern or Western for automatic calculation of body surface area.
BP(mmHg)
Enter the blood pressure of the patient in mmHg or kPa. Only numerical value is allowed.
Comments
Enter other information as comments. You can enter no more than 512 characters.