Field Name | Field Type | Value/ Options | Validation/ Logic |
Date of registration |
|
| Should be auto selected and updated when the volunteer logs in the application to do the screening. |
Photo | Camera | Optional | Should have face detection/ Facial recognition
Camera should identify & capture human face but not any objects
Show an Alert if Photo is not captured, just as reminder but Not Mandatory
Alert: "Do you like to Take Photo", Yes or No If "Yes", open Camera; If "No", go to next |
Beneficiary Status |
| Alive
Dead |
|
First Name | Text |
| Mandatory
Speech to text feature |
Last Name |
|
| Optional |
Age | Number (Years) |
| Mandatory
If DOB unknown, approximate age allowed |
Date of Birth | Date Picker |
| Populate Age automatically if entered |
Gender | Dropdown |
Male
Female
Transgender
Prefer not to say
| Mandatory
Speech to text feature |
Mobile Number | Number |
| Optional
Speech to text feature |
Village/ Hamlet | dropdown |
|
|
Marital Status | Spinner |
- Unmarried
- Married
- Divorced
- Separated
- Widow
- Widower
| - Not Applicable for Newborn/ Child/ Adolescent (Age 0 to less than 18 Years)
- Mandatory and editable
- Show this field once above Gender is selected
- Based on the 'Gender' values in this dropdown list should change as follows:
- In case of 'Gender' = "Female" show "Widow" and hide "Widower"
- In case of 'Gender' = "Male" show "Widower" and hide "Widow" Above in field 'Relationship with head of family' is selected as "Husband" or "Wife" then auto select "Married"
|
Husband's/ Wife's Name | Textbox | Is Conditionally Mandatory |
- Input method: Speech to Text feature
- Hide this field in case of 'Marital Status' = "Unmarried"
- Optional (Not Mandatory) in case of 'Marital Status' = "Divorced"
- Based on the Gender show label name as: 'Husband's' or 'Wife's Name'
- Accept alphabets only
- Character limit 50
- All letter should be in caps
|
Father's Name | Textbox |
| - Input method: Speech to Text feature
- Optional (Not Mandatory) in case of 'Gender' = "Female" and 'Marital Status' = "Married"
- Accept alphabets only
- Character limit 50
- All letter should be in caps
|
Mother's Name | Textbox |
| - Input method: Speech to Text feature
- Optional (Not Mandatory) in case of 'Gender' = "Female" and 'Marital Status' = "Married"
- Accept alphabets only
- Character limit 50
- All letter should be in caps
|
Community | Spinner |
- General
- SC
- ST
- OBC
- OC
- Not Given
| - Mandatory
- But it should be editable
|
Religion | Spinner | - Hindu
- Muslim
- Christian
- Sikhism
- Buddhism
- Jainism
- Parsi
- Other
- Not disclosed
| - Mandatory
- But it should be editable
|
Economic Status | Spinner | Is Mandatory Choose: |
|
Type of Residential area | Spinner | Choose: - Rural
- Urban
- Tribal
- Tea Garden
- Other
|
|
Other Type of Residential area | Textbox |
| - Enable if other is selected above
- Is Mandatory if other is selected above
- Allow Alphanumeric Character and special Characters
- Character limit 100
|
Occupation |
|
| |
Cancel | Button |
| If cancel is selected, a pop up message "Are you Sure?" with options "Yes" and "No" will come.
If selected "yes" navigate back to home page
If selected "no" then do not erase the patient health data and let the page remain open so it can be submitted by volunteer as sometime by mistake cancel button is clicked. |
Submit |
|
| On clicking this, it must display the Pop up msg "Patient Registered successfully"
This must store the data of the patient and display the required fields over the Beneficiary card
Ensure that data should go to server. |
