Patient | Alyssa

Booking Details

John Doe

PID 562588

Apt. ID

214523

Visit Category*

Walk-In

Future Apt.

Send to Triage

Edit Visit

Department *

Surgery

Doctor

Sateesh Talpade

OPD Nursing Station

NS OPD 2

Date

12-05-20

Time

12:50

Appointment Note

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Cancel Apt.

Validate Payment

Patient Billing Code

Social Security

Social Security No.

123456789

Validity Start date

01-12-2018

Validity End date

31-12-2019

Note

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Insurance

Insurance Company Name

Suftansa Insurance

Contract Name

213562

Plan Name

Safe Suftansa Pack

Validity Start date

01-12-2018

Validity End date

31-12-2019

Note

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Coverage Amount (฿)

Log Ref. Number

Ref # from the insurance website

Decline Validate

Company Contract

Company Name

Facebook

Contract Name

213562

Package Name

Social Safety Pack

Employee ID

1234567890

Note

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Coverage Amount (฿)

Log Ref. Number

Decline Validate

Cancel Apt. Save & Check In Save & Send to Triage

Rutana

Book Appoinment Page Header Name / Inner Page Name

Booking Details

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Social Security

Insurance

Company Contract