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 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']))

Speciality *

@else

Speciality *

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

Hospital/Clinic Address *

@else

Hospital/Clinic Address *

@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 *

OPD/IPD Registration No *

Gender *

Male Female

Age(in Years) *

City/Town *

State *

General Examination Findings

Pulse(minute) *

Weight(in Kg) *

Height(in cm) *

Type of skin*

Normal Sensitive Acne prone

Diagnosis

Suntan Sunburn Acne PMLE Any other

If any other, please specify

Treatment given

Sunscreen	Name of sunscreen
Moisturizer	Name of moisturizer
Depigmenting agent	Name of Depigmenting agent
Any Other

Sunscreen given	Frequency of application	Duration in weeks
Suncros	OD BID Every 2 hourly
Any Other Please Specify	OD BID Every 2 hourly

Patient {{ $iPatientNo }}

Doctor’s Details

Patient’s Details

General Examination Findings

Diagnosis

Treatment given

Please Specify