CareScan Staff Access

Enter your staff password to access the patient entry form

Patient Entry Form

Staff use only — entries require manager approval before becoming official records

This form is for recording visits in the manager's absence. All entries will be reviewed and approved before being added to the official database.

Patient Name *

Father / Mother / Guardian

Phone Number

CNIC

Age

Gender

Visit Date *

Referred By

Doctor *

Description / Test

Consultation Type

Consultation Fee (Rs.)

Online Consultation (Rs.)

Lab Fee (Rs.)

Procedure Fee (Rs.)

Discount (Rs.)

Payable (Rs.)

Payable: Rs. 0

Submitted By (Your Name) *