Patient Information / Uncategorized / By root234 Patient information n Patient Electronic Health Record Intake n n n Administrative Details n Unique Patient Number:n n Date Admitted:n n n n Patient Demographics n First Name:n n Middle Name:n n Last Name:n n Gender:n n–Select–nMalenFemalenOthern n Date of Birth:n n n n Address Information n Purok or Street:n n Barangay:n n City / Municipality:n n Province:n n Zip Code:n n n n Clinical Presentation & Evaluation n Signs and Symptoms:n n Types of Laboratories Performed:n n Diagnosis:n n Attending Physician:n n n Save Record to EHR Systemn