{AJAXCONTENT}

Personal Details
Prefix: | {PREFIXOPTIONS} | FName: | {FNAME} | MName: | {MNAME} | LName: | {LNAME}
CName:* | {CLIENTOPTIONS} | DOB: | {DOBDD}-{DOBMM}-{DOBYYYY} | ADate: | {ADDD}-{ADMM}-{ADYYYY} | Phone: | {PHONE}
Mobile: | {MOBILE} | Hospital Refference No: | {HOPITALREFNO} |
File Details
Complete File: | Yes No No | Pages: | {COMPPAGE} | Summary File: | Yes No No | Pages: | {SUMPAGE}
Radiology Images: | Yes No No | Pages: | {RADPAGE} | Other File: | Yes No No | Pages: | {OTHPAGE}
Cds: | Yes No No | No.of: | {NOOFCD} | Removable disk: | Yes No No | No.of: | {NOFOREM}
E-Mail: | Yes No No | No.of: | {NOOFEMA} |
Comments: | {COMMENTS}