DigiCon

@if(isset(session()->get('doctor')['vCentralCode'])) {{session()->get('doctor')['vCentralCode']}} @endif

@if(isset(session()->get('doctor')['vCentralCode']))

Logout

@endif

@csrf

@if(isset(session()->get('doctor')['vCentralCode']))

Back

@else

@endif

Patient {{$iPatientNo}}

(Kindly fill in the relevant information or tick, as appropriate.)

Doctor’s details

@if(isset(session()->get('doctor')['vCentralCode']))

Name *

@else

Name *

@endif

Registration No. *

Qualification *

@if(isset(session()->get('doctor')['vCentralCode']))

Hospital/Clinic Address *

@else

Hospital/Clinic Address *

@endif @if(isset(session()->get('doctor')['vCentralCode']))

Speciality *

@else

Speciality *

@endif @if(isset(session()->get('doctor')['vCentralCode']))

City *

@else

City *

@endif @if(isset(session()->get('doctor')['vCentralCode']))

State *

@else

State *

@endif

Patient’s Details

Initials *

Age(in Years) *

City/Town *

State *

Gender *

Male Female

General Examination Findings

Type of skin*

Normal

Sensitive

Acne prone

Diagnosis

Treatment given

Moisturizer given	Frequency of application	Duration in weeks
Moisturex Hydra gel cream	OD BID TID
Any Other (Please specify)	OD BID TID