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ABC medical group is focusing to provide quality care to all patients. Currently all patient management processes are handled

Each member in the group should prepare two input forms mapped to the functionalities of proposed system. The design should be an effective with necessary quality parameters (usability, understandability). (

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Answer #1

the front desk staff and billing department files two forms:

Put (Ö ) mark in relevant bracket.

PART-B

Name:

Gender:           M         F

Phone No:

Age:

18-2526-35          36-45           46-55            56-65            66-70

Department:

Health insurance:                              

     ( ) yes             ( ) no

date description charge

Put (\bullet) mark in relevant bracket.

PART-A

Name:

Gender:           M F

Phone No:

Age:

( )18-25 ( ) 26-35 ( ) 36-45 ( ) 46-55 ( ) 56-65 ( ) 66-70

Locality:

( )Urban ( ) Rural

Occupation:

( ) Student     ( ) Daily wage worker ( ) Business

( ) Employ(Govt/Pvt) ( ) Unemployed ( ) Retired

Marital Status:

Married          Unmarried           Divorced        

Literacy Status:

Literate        Illiterate                 

Level of Education:      Primary Secondary Graduate

Social Habits: Alcoholic                  Smoking                  Both         Others

Monthly Income:   Destitute (<6k) Poor (6k-12k) Lower class (12k-20k) Middle class(20k-60k)

Upper class(60k-2.4 lakh) Rich class(2.4 lakh-12 lakhs)    Wealthy(>12 lakhs)

Chief complaints:

Past Medical History:

Past Medication History:

Family History:

Allergies: Food Drug Nil Known Allergies

If Yes, Specify:

Diagnosis:

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