Patient Name /
Patient ID
Apt. ID Visit ID Req. Date/
Req. Time
Contact No. /
Email
Evidence Type /
Evidence ID
Payment Type Severity Status
Luis Hall
PID 681845
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Passport
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Normal Verify
Clui Reed
PID 921733
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Driving License
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Urgent Verify
Antonio Brluit
PID 432970
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Govt ID
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Urgent Verify
Amanda Wrilui
PID 893534
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Passport
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Normal Verify
Patient Name /
Patient ID
Apt. ID Visit ID Req. Date/
Req. Time
Contact No. /
Email
Evidence Type /
Evidence ID
Payment Type Status
Luis Hall
PID 681845
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Passport
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Accepted Edit
Clui Reed
PID 921733
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Driving License
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Declined Edit
Antonio Brluit
PID 432970
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Govt ID
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Accepted Edit
Amanda Wrilui
PID 893534
123456 123456 25-03-2019
16:45
+66 2 123 4567
jackdoe@email.com
Passport
EID 362547852325
1 Ins 2 C C 3 S S 4 S P Accepted Edit