Medica

Settings

Activity

Center

MOH

GN Devisions

Name of vaccine

Batch number

Dose

Age

Type

Password

NIC Number:

Family

Date Of Birth:

Age:

Mobile No:

Passport:

Gender:

Male

Female

Health ID :

G N Division :

Hospitalized

Name:

PHI Area :

Deceased

Address:

Sample Files

Quarantine Info

Quarantine Type :

Center :

Source :

Dipature Country :

Date :

Last Contact Date :

Quarantine Start Date :

Quarantine Till :

Number Of Days :

Latitude :

Longitude :

Sample File Download

PCR Result Info

Date :

MOH :

Serial Number :

Lab Reference Number :

Lab :

Result :

Result Receive Date :

CT Value Target 1 :

CT Value Target 2 :

Remarks :

Sample File Download

Vaccination Info

Date :

Center :

Name Of Vaccine :

Batch Number :

Dose :

Category :

Remarks :

Latitude :

Longitude :

Sample File Download

Last Quarantine Records

Last Vaccinated Records

Date	GN Division	Name	Address	Age	Gender	NIC	Contact Number	Name of Vaccine	Center	Dose	Status

Last PCR Test Records

PCR Date	MOH	Serial No	Name	Address	Age	Gender	ID No	Contactnumber	Remarks	Result	Lab Name

First Name	Last Name	ID

Past Medical History

ID	Name	Year	Comments	Delete

Other

Past Surgical History:

Allergies

No Drug Allergy

Drug Allergies:

Food Allergies:

Other

Remarks: