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']))

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@else

@endif

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

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

Name *

@else

Name *

@endif

ID No. *

Initials *

Serial No.*

Sex *

Age(in Years) *

Wt (kg)*

Diagnosis*

Co-existing diagnosis, if any

Raciper D

Duration of treatment:

7 Days 14 Days 21 Days 30 Days

Heartburn, epigastric pain and nausea

Dysphagia, chest pain and dry cough