{% if case.id %}

Patient Information

{{ render(controller('App\\Controller\\PatientController::personalInfo', {'id': case.patient.id})) }}

{% endif %}

Clinical Examination and History

{% if not case.id %}

{{ form_label(form.patient, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.patient, {'attr': { 'class': 'form-control' }}) }} {{ form_errors(form.patient) }}

{% endif %}

{{ form_label(form.patientCategory, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.patientCategory, {'attr': { 'class': 'form-control select-picker ro-select' }}) }} {% else %} {{ form_widget(form.patientCategory, {'attr': { 'class': 'form-control select-picker' }}) }} {% endif %} {{ form_errors(form.patientCategory) }}

{{ form_label(form.familyHistory, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold'}}) }}

{{ form_widget(form.familyHistory, {'attr': { 'class': 'form-control', 'maxlength':'50', 'onkeydown':"return /[0-9a-zA-Z ]/i.test(event.key)"}}) }} {{ form_errors(form.familyHistory) }}

{{ form_label(form.currentDiseaseHistory, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.currentDiseaseHistory, {'attr': { 'class': 'form-control', 'maxlength':'50', 'onkeydown':"return /[0-9a-zA-Z ]/i.test(event.key)"}}) }} {{ form_errors(form.currentDiseaseHistory) }}

{{ form_label(form.medicalHistory, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.medicalHistory, {'attr': { 'class': 'form-control', 'maxlength':'50', 'onkeydown':"return /[0-9a-zA-Z ]/i.test(event.key)"}}) }} {{ form_errors(form.medicalHistory) }}

{{ form_label(form.medicineHistory, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.medicineHistory, {'attr': { 'class': 'form-control', 'maxlength':'50', 'onkeydown':"return /[0-9a-zA-Z ]/i.test(event.key)"}}) }} {{ form_errors(form.medicineHistory) }}

{{ form_label(form.diseaseCategory, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.diseaseCategory, {'attr': { 'class': 'form-control ro-select' }}) }} {% else %} {{ form_widget(form.diseaseCategory, {'attr': { 'class': 'form-control', 'data-remote-url': path('case_symptom_json') }}) }} {% endif %} {{ form_errors(form.diseaseCategory) }}

{{ form_label(form.symptoms, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.symptoms, {'attr': { 'class': 'form-control ro-select', 'maxlength':"50"}}) }} {% else %} {{ form_widget(form.symptoms, {'attr': { 'class': 'form-control', 'data-remote-url': path('case_diagnosis_data_json') }}) }} {% endif %} {{ form_errors(form.symptoms) }}

{{ form_label(form.clinical_patterns, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.clinical_patterns, {'attr': { 'class': 'form-control ro-select' }}) }} {% else %} {{ form_widget(form.clinical_patterns, {'attr': { 'class': 'form-control' }}) }} {% endif %} {{ form_errors(form.clinical_patterns) }}

{{ form_label(form.provisional_examinations, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.provisional_examinations, {'attr': { 'class': 'form-control ro-select' }}) }} {% else %} {{ form_widget(form.provisional_examinations, {'attr': { 'class': 'form-control' }}) }} {% endif %} {{ form_errors(form.provisional_examinations) }}

{{ form_label(form.localExamination, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.localExamination, {'attr': { 'class': 'form-control', 'oninput':"this.value = this.value.replace(/[^0-9a-zA-Z ]/g, '')"}}) }} {{ form_errors(form.localExamination) }}

{{ form_label(form.provisional_diagnosis, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.provisional_diagnosis, {'attr': { 'class': 'form-control ro-select' }}) }} {% else %} {{ form_widget(form.provisional_diagnosis, {'attr': { 'class': 'form-control' }}) }} {% endif %} {{ form_errors(form.provisional_diagnosis) }}

{{ form_label(form.icd10CauseGroup, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.icd10CauseGroup, {'attr': { 'class': 'form-control ro-select' }}) }} {% else %} {{ form_widget(form.icd10CauseGroup, {'attr': { 'class': 'form-control' }}) }} {% endif %} {{ form_errors(form.icd10CauseGroup) }}

{{ form_label(form.icd10CauseSubGroup, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.icd10CauseSubGroup, {'attr': { 'class': 'form-control ro-select' }}) }} {% else %} {{ form_widget(form.icd10CauseSubGroup, {'attr': { 'class': 'form-control', 'data-remote-url': path('case_suggested_tests_json') }}) }} {% endif %} {{ form_errors(form.icd10CauseSubGroup) }}

{{ form_label(form.isLab, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_tests is defined and case_tests is not empty %} {{ form_widget(form.isLab, {'attr': { 'disabled': '' }}) }} {% else %} {{ form_widget(form.isLab) }} {% endif %}

{% if case_tests is defined %}

{% for test in case_tests %}

{{ test.name }} {% if test.is_general != 1 and test.method %}({{ test.method }}){% endif %} {% if test.is_general != 1 %} {% if test.number %} {% if test.result %} {% else %} {% endif %} {% else %} {% endif %} {% else %} {% if test.file_url %} {% else %} {% endif %} {% endif %}

{% endfor %}

{% endif %}

{{ form_label(form.isMedicine, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_medicines is defined and case_medicines is not empty %} {{ form_widget(form.isMedicine, {'attr': { 'disabled': '' }}) }} {% else %} {{ form_widget(form.isMedicine) }} {% endif %}

Observation

{{ form_label(form.temparature, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.temparature, {'attr': { 'class': 'form-control','min':'1', 'maxlength':'3', 'oninput':"this.value = this.value.replace(/[^0-9]/g, '')"}}) }}

°F

{{ form_label(form.cns, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.cns, {'attr': { 'class': 'form-control','autocomplete':'off', 'maxlength':'20', 'oninput':"this.value = this.value.replace(/[^0-9a-zA-Z]/g, '')" }}) }} {{ form_errors(form.cns) }}

{{ form_label(form.endrocine, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.endrocine, {'attr': { 'class': 'form-control','autocomplete':'off', 'maxlength':'20', 'oninput':"this.value = this.value.replace(/[^0-9a-zA-Z]/g, '')"}}) }} {{ form_errors(form.endrocine) }}

{{ form_label(form.excretory, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.excretory, {'attr': { 'class': 'form-control','autocomplete':'off', 'maxlength':'20', 'oninput':"this.value = this.value.replace(/[^0-9a-zA-Z]/g, '')" }}) }} {{ form_errors(form.excretory) }}

{{ form_label(form.pulse, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.pulse, {'attr': { 'class': 'form-control','autocomplete':'off', 'maxlength':'3', 'oninput':"this.value = this.value.replace(/[^0-9]/g, '')"}}) }}

/min

{{ form_label(form.bpUpper, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

Sys

{{ form_widget(form.bpUpper, {'attr': { 'class': 'form-control','autocomplete':'off', 'maxlength':'6', 'oninput':"this.value = this.value.replace(/[^0-9.]/g, '')" }}) }}

Dia

{{ form_widget(form.bpLower, {'attr': { 'class': 'form-control','autocomplete':'off', 'maxlength':'6', 'oninput':"this.value = this.value.replace(/[^0-9.]/g, '')" }}) }}

{{ form_label(form.respiration, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.respiration, {'attr': { 'class': 'form-control respiration','autocomplete':'off', 'maxlength':'4', 'oninput':"this.value = this.value.replace(/[^0-9]/g, '')"}}) }}

/min

{{ form_label(form.auscultation, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.auscultation, {'attr': { 'class': 'form-control','autocomplete':'off', 'maxlength':'20', 'oninput':"this.value = this.value.replace(/[^0-9]/g, '')"}}) }} {{ form_errors(form.auscultation) }}

{{ form_label(form.icd10Disease, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.icd10Disease, {'attr': { 'class': 'form-control', 'style': 'width: 100%', 'data-remote-url': path('case_suggested_advice_treatment_json') }}) }} {{ form_errors(form.icd10Disease) }}

{{ form_label(form.ncds, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.ncds, {'attr': { 'class': 'form-control', 'style': 'width: 100%', 'data-remote-url': path('case_suggested_advice_treatment_json') }}) }} {{ form_errors(form.ncds) }}

{{ form_label(form.confirmedDiagnosis, (is_granted('ROLE_DOC') or is_granted('ROLE_DENT') ? '' : 'Confirmed Diagnosis'), {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.confirmedDiagnosis, {'attr': { 'class': 'form-control','autocomplete':'off' }}) }} {{ form_errors(form.confirmedDiagnosis) }}

{{ form_label(form.isWard, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% if case_ward_medicines is defined and case_ward_medicines is not empty %} {{ form_widget(form.isWard, {'attr': { 'disabled': '' }}) }} {% else %} {{ form_widget(form.isWard) }} {% endif %}

{{ form_label(form.ward, '', {'label_attr': { 'class': 'non-req col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.ward, {'attr': { 'class': 'form-control select-picker' }}) }}

{{ form_label(form.isOpinion, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_label(form.isReferral, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{% for child in form.ref_type %} {{ form_widget(child, {'attr': { 'class': 'kt-radio' }}) }} {{ form_label(child, null, { 'label_attr': { 'class': 'non-req' }}) }} {{ form_errors(child) }} {% endfor %}

{{ form_label(form.ref_state, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_state, {'attr': { 'class': 'form-control select-picker','data-ajax-url': path('location_district_json') }}) }} {{ form_errors(form.ref_state) }}

{{ form_label(form.ref_district, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_district, {'attr': { 'class': 'form-control select-picker','data-ajax-url': path('location_taluka_json') }}) }} {{ form_errors(form.ref_district) }}

{{ form_label(form.ref_taluka, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_taluka, {'attr': { 'class': 'form-control select-picker','data-ajax-url': path('location_village_json') }}) }} {{ form_errors(form.ref_taluka) }}

{{ form_label(form.ref_center_type, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_center_type, {'attr': { 'class': 'form-control select-picker','data-ajax-url': path('hospital_list_by_type') }}) }} {{ form_errors(form.ref_center_type) }}

{{ form_label(form.ref_center, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_center, {'attr': { 'class': 'form-control select-picker' }}) }} {{ form_errors(form.ref_center) }}

{{ form_label(form.ref_doc_cat, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_doc_cat, {'attr': { 'class': 'form-control select-picker','data-ajax-url': path('doctor_list_by_category') }}) }} {{ form_errors(form.ref_doc_cat) }}

{{ form_label(form.ref_doctor, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_doctor, {'attr': { 'class': 'form-control select-picker','data-ajax-url': path('email_by_doctor') }}) }} {{ form_errors(form.ref_doctor) }}

{{ form_label(form.ref_email, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_email, {'attr': { 'class': 'form-control' }}) }} {{ form_errors(form.ref_email) }}

{{ form_label(form.ref_note, '', {'label_attr': { 'class': 'col-3 col-form-label' }}) }}

{{ form_widget(form.ref_note, {'attr': { 'class': 'form-control', 'rows': '4', 'cols': '50' }}) }} {{ form_errors(form.ref_note) }}

{% for child in form.isClosed %} {{ form_widget(child, {'attr': { 'class': 'kt-radio' }}) }} {{ form_label(child, null, { 'label_attr': { 'class': 'non-req' }}) }} {{ form_errors(child) }} {% endfor %}

{{ form_label(form.closureReason, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.closureReason, {'attr': { 'class': 'form-control select-picker' }}) }} {{ form_errors(form.closureReason) }}

{{ form_label(form.followUpDate, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.followUpDate, {'attr': { 'class': 'form-control','autocomplete':'true','readonly':'true' }}) }} {{ form_errors(form.followUpDate) }}

Consent

For saving patient's records For seeing history of patient's past records

Payment

Amount

Notify By

SMS WhatsApp Email

Diagnostics

General Tests

{{ form_label(form.lab_tests, '', {'label_attr': { 'class': 'col-3 col-form-label font-weight-bold' }}) }}

{{ form_widget(form.lab_tests, {'attr': { 'class': 'form-control', 'style': 'width: 100%' }}) }} {{ form_errors(form.lab_tests) }}

Suggested Tests

Radiology Tests

{% if case.id %} {% for test in rad_tests %} {% endfor %} {% endif %}

Test	Instructions
{{ test.name }}	{{ test.instruct }}

Prescription

Confirmed Diagnosis: {% if case.id %} {{ case.icd10Disease ? case.icd10Disease : '—' }} {% else %} — {% endif %}
Supportive Advice: {% if case.id %} {{ case.icd10Disease ? case.icd10Disease.supportiveAdvice : '—' }} {% else %} — {% endif %}
Pharmaceutical Treatment: {% if case.id %} {{ case.icd10Disease ? case.icd10Disease.pharmaTreatment : '—' }} {% else %} — {% endif %}

{% if case.id %} {% for medicine in case_medicines %} {% endfor %} {% endif %}

Type	Medicine	Dose	Freqency	Days	Patient Notes
{{ medicine.medicine_type }}	{% if medicine.is_referral %} R {% endif %} {% if medicine.is_opinion %} E {% endif %} {{ medicine.name }}	{{ medicine.dose }}	{{ medicine.frequency }}	{{ medicine.num_days }}	{{ medicine.notes }}	{% if (medicine.is_opinion or medicine.is_referral) and not medicine.is_rejected and app.user.id == case.doctor.id %} {% endif %}

{{ form_label(form.pharmacyPatientNotes, '', {'label_attr': { 'class': 'font-weight-bold' }}) }} {{ form_widget(form.pharmacyPatientNotes, {'attr': { 'class': 'form-control' }}) }} {{ form_errors(form.pharmacyPatientNotes) }}

{{ form_label(form.pharmacyStaffNotes, '', {'label_attr': { 'class': 'font-weight-bold' }}) }} {{ form_widget(form.pharmacyStaffNotes, {'attr': { 'class': 'form-control' }}) }} {{ form_errors(form.pharmacyStaffNotes) }}

Medicines for Ward

{% if case.id %} {% for medicine in case_ward_medicines %} {{ medicine.notes ? medicine.notes : '—' }} {% endfor %} {% endif %}

Type	Medicine	Dose	Freqency	Days	Staff Notes
{{ medicine.medicine_type }}	{% if medicine.is_emergency %} E {% endif %} {{ medicine.name }}	{{ medicine.dose }}	{{ medicine.frequency }}	{{ medicine.num_days }}

{{ form_label(form.wardStaffNotes, '', {'label_attr': { 'class': 'font-weight-bold' }}) }} {{ form_widget(form.wardStaffNotes, {'attr': { 'class': 'form-control' }}) }} {{ form_errors(form.wardStaffNotes) }}

{% if opinions is defined and opinions is not empty %}

Expert Opinions

{% for opinion in opinions %} {% else %} {% endfor %}

Sr. No.	Date	Expert Doctor	Department	Hospital	Opinion
{{ loop.index }}	{{ opinion.updated_at\|date('d/m/Y') }}	{{ opinion.doctor }}	{{ opinion.department }}	{{ opinion.hospital }}	{{ opinion.expert_opinion\|raw }}
No records found

{% endif %}