|
Patient Id:
{{patient.primaryIdentifier.identifier}}
|
|
|
Issue Date:
{{patient.registrationDate | bahmniDate}}
|
|
Name:
{{patient.givenName + (patient.middleName ? (" " + patient.middleName) : "") + (patient.familyName ? (" " + patient.familyName) : "")}}
|
|
Age:
{{patient.age | age}}
|
|
|
Gender:
{{patient.gender}}
|
|
Contact No:
{{patient.phoneNumber}}
|
|
|
![]()
|
|
Address:
{{patient.address.address1 ? patient.address.address1 + "," : ""}}
{{patient.address.address2 ? patient.address.address2 + "," : ""}}
{{patient.address.address3 ? patient.address.address3 + "," : ""}}
{{patient.address.address4 ? patient.address.address4 + "," : ""}}
{{patient.address.address5 ? patient.address.address5 + "," : ""}}
{{patient.address.countyDistrict ? patient.address.countyDistrict + "," : ""}}
{{patient.address.stateProvince}}
|
![]()
|
|
{{ "REGISTRATION_SLIP_DISCLAIMER" | translate }}
|
|
