Prescription

Patient Name: {{patientData[3]}} {{patientData[4]}} {{patientData[5]}}
Gender: {{patientData[6]}} DOB: {{patientData[7]}}
Phone No.: {{patientData[26]}}
Address: {{patientData[22]}}
Prescription Date: {{diet[0][2]}}

Doctor Name: {{docData[3]}} {{docData[4]}} {{docData[5]}} , {{docData[10]}}
Specality: {{docData[9]}}
Address: {{docData[11]}}
Phone No.: {{docData[8]}}
Email: {{docData[2]}}

Reason for Visit


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Vital Signs - Last Recorded

BP	Pulse	Temp	Ht	Wt	BMI
{{vitalSign[0][1]}}	{{vitalSign[0][2]}}	{{vitalSign[0][3]}}	{{vitalSign[0][4]}}	{{vitalSign[0][5]}}	{{vitalSign[0][6]}}

Allergies


{{elemnt[2]}}

Medicine

Drug Name	Dosage	Frequency	Instructions
{{elemnt[4]}}	{{elemnt[1]}}	{{elemnt[2]}}	{{elemnt[3]}}

Test Name

Test Name	Instructions
{{elemnt[2]}}	{{elemnt[1]}}

Diet


{{diet[0][1]}}

First Name

First Name is required.

First Name has to be less than 14 characters long.

Middle Name

Last Name

Last Name is required.

Last Name has to be less than 14 characters long.

Date of Birth (DD-MM-YYYY)

Date of Birth is required.

Invalid Date of Birth

Gender

Male

Female

Others

Allergies

Allergy is required.
Add

Vital Signs

BP

BP is required.

Pulse

Pulse is required.

Temp

Temp is required.

Ht

Ht is required.

Wt

Wt is required.

BMI

BMI is required.

Reason for Visit

Reason for Visit
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Medicine

Drug is required.

Dosage

Frequency

Instructions
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Test Name

Instruction
Add

Diet

Instruction