Submit a patient report

Add a structured record to this patient's NHCIP history. Choose the record type and complete the relevant fields. Consent rules determine who can later view what you submit.

–

No patient selected

Verify a patient first

—

1 Record type

Select what you are contributing. The form adapts to the fields required.

Appointment / encounter

Lab / test result

Prescription / dispense

Vitals / clinical

Insurance / claim

Other record

2 Appointment / encounter details

Date & time *

Encounter type *

Department / specialty *

Attending clinician *

Reason / presenting complaint

Diagnosis / notes (ICD-10 optional)

2 Laboratory / test result

Test / panel name *

Specimen

Collection date *

Result date

Results

AnalyteValueUnitReference

Blood group (if applicable)

Rh type (if applicable)

Genotype / Hb (if applicable)

Interpretation / comment

2 Prescription / dispensing

Medication *

Strength / form *

Dose & frequency *

Duration

Quantity dispensed *

Dispense date *

Prescriber

Status

Pharmacist notes / counselling

2 Vitals & clinical

Visit date *

Blood pressure

Pulse

Temperature

Respiratory rate

SpO₂

Weight / height

Allergy to record (optional)

Chronic condition (optional)

Immunisation given (optional)

Referral to

2 Insurance / claim

Scheme *

Member / enrolee ID *

Plan / package

Coverage status *

Authorisation / claim no.

Claim amount (₦)

Service / claim description

2 Other record

Record type *

Date *

Title / summary *

Details

3 Sharing & consent

Set how sensitive this record is. NHCIP uses this to decide whose consent is required before another provider can view it.

Signed & audit-logged

Report submitted

The record has been added to Adeyemi, A. O.'s NHCIP history and matched successfully.

Reference: NHCIP-RP-2026-000000

View patient record →