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Transfer of Patient A3981-DA Mobile App

This mobile app is used to file a transfer request for a patient from one location to another. The user is to provide information regarding the patient including health status, identification information, conditions, diagnosis and reason for transfer. The app also has a signature capability for approval.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Transfer of Patient A3981-DA Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    HOSPITAL

  • Ico date

    DATE

  • Ico dropdown

    PATIENT IS

  • Ico integer

    NUMBER OF ATTENDANTS NECESSARY

  • Ico textbox

    PROBABLE PERIOD OF FURTHER HOSPITALIZATION

  • Ico textbox

    ACCOMMODATIONS REQUIRED

  • Ico multiline

    PATIENT'S IDENTIFICATION (Use admitting or ward plate, if available.

  • Ico textbox

    PRESENT CONDITION

  • Ico multiline

    DIAGNOSIS

  • Ico multiline

    PATIENT'S HOME ADDRESS

  • Ico multiline

    REASON FOR TRANSFER

  • Ico textbox

    RECOMMEND APPROVAL (Chief, Department or Service)

  • Ico textbox

    APPROVED FOR THE COMMANDING OFFICER

  • Ico signature

    SIGNATURE

  • Ico date

    DATE

  • ...and More!

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