New Patient Registration

New patient registration — agent drafts, clerk confirms identity.

New patient

Confirm this is the right person before saving. SHA fingerprint or SHA OTP is checked at check-in — we do not send another code.

1. Coverage / payer default

Payment type *Company / subtype *PlanDefault bill type

2. Identity & demographics

Salutation *Sex *First name *Surname *Other / middleDOB YYYY-MM-DD *Age *National ID *Member / staff no *Member type *

3. Personal & location

Location narrows as you go: county → sub-county → area/town. Type to filter the list.

Guardian *

County *

Sub county *

Area / town *

Citizenship *

Address 1City

Occupation

Marital status

Blood group

4. Contact / NOK

Mobile *Next of kin *NOK tel *NOK relation *

5. Consent / channel (Bliss)

Who owns the phone we can text?OK to send queue number and visit-status texts to this phone (not clinical consent)Queue texts viaClinical WhatsApp (status / Rx ready — no result bodies)Marketing / promo WhatsAppHas smartphoneTelemedicine interestSHA eligibility

I confirm this is the correct personForce create despite duplicate candidates (IdentityMatch override)