Patient Registration
Create your account to access your medical records nationwide
Personal Information
First Name
Please enter your first name
Last Name
Please enter your last name
National ID Number
Please enter your National ID
Date of Birth
Please select your date of birth
Gender
Select Gender
Male
Female
Other
Please select your gender
Blood Type
Select Blood Type
A+
A-
B+
B-
AB+
AB-
O+
O-
Unknown
Please select your blood type
Next: Contact Info
Contact Information
Email Address
Please enter a valid email address
Phone Number
Please enter your phone number
Physical Address
Please enter your address
District of Residence
Select District
Kampala
Wakiso
Mukono
Jinja
Mbale
Gulu
Mbarara
Fort Portal
Other
Please select your district
Previous
Next: Medical Info
Medical Information
Known Allergies
Chronic Conditions
Current Medications
Create Password
Please create a password (min 8 characters)
Confirm Password
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I consent to the storage and sharing of my medical information through the Uganda National Medical Database system as described in the
Privacy Policy
.
You must agree to the terms
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