Hospital Information System
Patient Details
Edit Patient Registration
Referral
Yes
No
Reg. Number
Consent(NABIDH)
Approve
Reject
First Name*
Last Name*
Date of Birth
Gender
Male
Female
Other ID
Mobile*
+971
+966
+965
+968
+974
+973
+962
+964
+963
+961
+967
+970
Designation
Emirate
Abu Dhabi
Dubai
Sharjah
Ajman
Fujairah
Ras Al Khaimah
Umm Al Quwain
Package Utilization
Yes
No
Referral
Encounter Type*
Select
Consultation
Emergency
Follow-up
Admission
Middle Name
Visa Type*
Resident
Visit
Employment
Student
Age*
Yr
Mo
Wk
Dy
Nationality*
Select nationality
UAE
India
Pakistan
Philippines
Egypt
Bangladesh
Nepal
Emirate ID
Labour Card No
Language Preferable
English
Arabic
Hindi
Malayalam
Urdu
Tagalog
Email*
Registration Date
Consultation Details
Department*
General Medicine
Pediatrics
Orthopedics
Cardiology
Dermatology
ENT
Gynecology
Doctor Name*
Dr. Ahmed Khan
Dr. Fatima Al Ali
Dr. Youssef Abdallah
Dr. Sara Ibrahim
Dr. Khaled Al Mansoori
Dr. Laila Hassan
Insurance Details
Insurance
Yes
No
Sub
Insurance
Provider
Network Type
Card No
Effective From
Insurance Policy
Cert No
Dependent No
Policy No
Chronic Indicator
No
Yes
Deductible (AED)
Co-Pay %
Min - Max
Consultation
Lab
For All
For Each
Radiology
For All
For Each
Treatment
For All
For Each
Medicine
For All
For Each
Dental
For All
For Each
Maternity
For All
For Each
Invoice - Max Insurance Liability
AED
Pre-Approval Limit
AED
Eligibility Status
Eligible
Ineligible
Reset
Update