Patient Registration Form


Download                                          (Also check - Policy and Procedure of Patient's registration)
PATIENT REGISTRATION FORM
Patient’s name

Date of registration

Gender
  Male / female
Date of Birth

Guardian (In case of minor patient)

Relationship

Address

Mobile No:

Landline No:

Email ID

Occupation

Health Insurance available
Yes / No
Name of insurer

Referring doctor

FOR EMERGENCY SITUATION
Name of person to be contacted

Relationship

Contact No -1

Contact No. - 2

I state that all information provided above is correct. I understand the information is being collected to register me and enable me to access the services of this hospital.
Signature of patient / guardian

Date / Time

Yorumlar

Yorum Gönder

Bu blogdaki popüler yayınlar

Emergency department checklist and quality indicators for NABH accreditation preparation

Emergency is an integral part of any hospital. Quality of emergency care depends upon several factors related to its infrastructure, design and processes. In NABH standards, there are several requirements that relates to the functioning of emergency and it must be taken care of by a hospital while preparing for accreditation. Below is the list of all such requirements which has been picked from NABH standards and observations made during assessments.       1.        Requirements related to Infrastructure and design of emergency department a.        Emergency department should be on ground floor OR its entrance should be easily accessible by ambulance b.        It should have a separate and dedicated entry. The road should reach till the emergency entrance for making it accessible to ambulance. The road should also allow for easy U-turn of the ambulance. ( Please also see the checklist of Ambulance ) c.        The main entrance of the emergency should be wide enough for easily moving 2
Devamı

It's Still the Economy Stupid

Resim
Once again Americans are rallied to fight against the result (high prices) rather than what caused the high prices. More money is thrown at the diagnosis leaving less remaining for prevention of high health care costs and prices. The process is great for those who write the articles, capture the attention, and enrich themselves. It is also the easy choice. Exposing high health care prices as evil takes no effort at all. The real harm is done by those who promote what seems to be popular as they distract Americans from the real causes of high health care costs. The Biomedical and Micromanagement Waves that have long shaped runaway health care costs are the result of the same influences that shape higher prices and less for more Americans - by design. Higher costs are the result of advantages of designs that favor those bigger, those most organized, those who prepare to profit from the newest designs or implement them to their advantage, and those in the right locations serving the
Devamı

Oregon PCMH Saved 240 Million But Spent Over 250 Million

Resim
The latest headlines spout 250 million saved for Oregon in the movement to Primary Care Medical Home. Claims of savings often fail to consider the additional costs of an intervention or the supplemental government or foundation funding required. Based on $105,000 additional cost per primary care physician per year the following table demonstrates $250 million to 1 billion dollars more in cost for primary care medical home across Oregon. It is important to consider not just the savings, but also the higher costs of new models. Specifics are not given but the impact of the primary care medical home can be estimated across the number of clinics that could participate and the doctors per clinic over a 2 or 3 year period. The number of doctors may be small compared to actual. The high and low levels are shown along with a possible average cost. If studies involved less than 2 years they should not have gained print. The limitations in new studies with new measurements as measured and analy
Devamı