- Vitals
- Weight: Kilograms
- Last Updated: Date the information was last updated
- Smoker
- Anti Smoking Treatment
- Never Smoked
- Not now but was a
- Yes and still smoke
- Height: Centimetres
- Hair
- Black
- Blonde
- Brown
- Dark Brown
- Light Brown
- Red
- Sandy
- Complexion
- Brown
- Dark
- Fair
- Olive
- White
- Blood Group
- A+
- A-
- AB+
- AB-
- B+
- B-
- O+
- O-
- Blood Pressure
- High
- Low
- Normal
- *Nationality *
- African
- Caucasian
- Islander
- Oriental
- Ethnic Origin
- Asians
- Caucasian
- European
- Middle East
- Native African
- Religion
- Anglican
- Baptist
- Buddhism
- Christian Science
- Christianity
- Church of Christ
- Church of England
- Coptic
- Eastern Orthodox
- Episcopalian
- Evangelical Reformed
- Hinduism
- Islam
- Jehovah’s Witness
- Latter-day Saint
- Lutheran
- Melkite
- Methodist
- Mormon
- Mormonism
- Orthodox Christianity
- Pentecostal
- Presbyterian
- Roman Catholic
- Seven Day Adventist
- Uniat
- Health Cover Details
- Medicare Number: Card Number
- Expiry Date: Card Expiry
- Private Health Fund: Name of the Private Health Fund
- Number: Card Number
- Member Since: Date the membership started
- Type of Cover: Level of cover under the membership
Revision:
5
Last modified:
Nov 26, 2019