Patient Registration

Please complete all steps. * required.

needsdoctor

Patient Registration

Complete all steps to publish your profile faster & get better care suggestions.

✓ Faster appointment booking
✓ Store vitals & medical reports
✓ Personalized doctor recommendations
✓ Secure profile & privacy controls

General

Name, DOB, gender, photo, contact

Contact

Address, country/state/city, pin

Medication

Frequency, dose, reports

Vitals

BP, pulse, temp, RR

Register Mail

Email + password setup

Tip

Upload prescription/report in Step-3 to help doctors understand history quickly.

👤 General Details

Full Name

Enter full name.

Date of Birth

Select full DOB.

Gender

Male

Female

Select gender.

Marital Status

Married

Unmarried

Upload Your Image

JPG/PNG/WebP up to 2MB.

Contact Number

Enter valid contact number.

📍 Address & Contact

Current Address

Enter current address.

Permanent Address

Country

Select a country.

State

Select a state.

City

Select a city.

Zip/Pin

💊 Medication History

Frequency

Route

Dose

Dose (Alt)

Start Date

End Date

Upload Prescription/Report

❤️ Vitals

Vitals Date

Temperature (°C)

Pulse (bpm)

Systolic BP (mmHg)

Diastolic BP (mmHg)

Respiratory Rate (rpm)

📧 Register Mail

Enter valid email.

Alternative Email

Password

Password required (8+).

Confirm Password

Passwords must match.