Register patient

Only the full name is required. Everything else can be added later.

1. Personal details

Full name required

As it should appear on bills. A single name is fine.

First name (optional)

Middle name (optional)

Surname (optional)

Preferred name (optional)

The name the patient likes to be called. Searchable.

Sex (optional)

Age (optional)

Date of birth is known Estimate the age Unknown

Photograph (optional)

Choose photo

JPEG, PNG or WebP · up to 2 MB. Large phone photos are reduced automatically.

Nationality, identification and other details (optional)

Nationality (optional)

Type to search the list of countries.

Marital status (optional)

Identification type (optional)

National ID or passport number (optional)

Shown masked (•••• 1234) everywhere after saving. Registration without identification is allowed.

Occupation (optional)

Preferred language (optional)

2. Contact and address (optional)

Primary telephone (optional)

Alternative telephone (optional)

Email address (optional)

Village or street (optional)

Parish (optional)

Subcounty (optional)

District (optional)

Or county / region outside Uganda.

Country (optional)

3. Next of kin (optional)

Next of kin's full name (optional)

Relationship (optional)

Next of kin's telephone (optional)

4. Emergency contact (optional)

Same as next of kin

Emergency contact name (optional)

Relationship (optional)

Emergency telephone (optional)

5. Parent or guardian (optional)

For children, or adults who need someone to act for them. The guardian can be different from the next of kin and the emergency contact.

Parent or guardian's full name (optional)

Relationship to patient (optional)

Parent or guardian's telephone (optional)

CancelOnly billing details are recorded here — no clinical information.