BP
Pulse
Ht........... cm
Wt........... kg
Temp
R/R
SPO2
Pain
Allergy, if any
Hospital No: {{pat.PatientCode}}
Patient Name: {{pat.ShortName}}
Age/Sex: {{pat.Age}} / {{pat.Gender}}
Address: {{pat.Address}}
Contact Number: {{pat.PhoneNumber}}
Referred By: {{patVisit.PerformerName}}
Date: {{date}}
BP : {{vitals.BPSystolic}}/{{vitals.BPDiastolic}}
Pulse : {{vitals.Pulse}}
Temp : {{vitals.Temperature}} {{vitals.TemperatureUnit}}
Wt : {{vitals.Weight}} {{vitals.WeightUnit}}
Ht : {{vitals.Height}} {{vitals.HeightUnit}}
BMI : {{vitals.BMI}}
SPO2 : {{vitals.SpO2}}
DM:
HTN:
F/H Kidney Disease:
BP : {{vitals.BPSystolic}}/{{vitals.BPDiastolic}}
Pulse : {{vitals.Pulse}}
Temp : {{vitals.Temperature}} {{vitals.TemperatureUnit}}
Wt : {{vitals.Weight}} {{vitals.WeightUnit}}
Ht : {{vitals.Height}} {{vitals.HeightUnit}}
BMI : {{vitals.BMI}}
SPO2 : {{vitals.SpO2}}
Date: {{date}}
HIS No: {{pat.PatientCode}}