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Demo: This is a demo site. Please only enter fake data into this site. Data may be reset at any point.

Personal and contact details

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OPAS ID
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NHS Number
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MRN Number
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Date of birth
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GP Practice
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Mobile
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Landline
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Email
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Address
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Demographics

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Ethnic group
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Gender
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Lives alone?
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Disabilities / LTCs
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Disabilities / LTCs Notes
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Unpaid carer?
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Relevant medical history

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Relevant medical history: -
Disability or long term condition: Unknown
Mobility issues: -
Existing package of care: -
Next of kin*: -
* This is an old field that can no longer be edited. Please use 'Actions > Add contact' to record 'Next of kin' going forwards.

Passed away
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This action will mark the client as deceased. If the client has any open cases, they will need to be closed separately.

Expected format: dd/mm/yyyy