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Example of New Application
 

Please provide the following information to propose a new data tracking application.         

Proposed Application Name (Max 50 chars):       Desktop Health Records
Application Short Description (Max 100 chars):       Manage Health Records on your PC with no privacy concerns

The first 3 fields are required and will uniquely identify a data record in the software after it is built.
Patient Name
Date Symptom
Started Symptom Name

The following fields are optional but please try to provide as many as you can to define the data to be tracked
Symptom Description
Date Symptom Ended
Date of Visit
Doctor Name
Type of Doctor
Doctors Phone Number
Doctors Location
Drugs prescribed
Referred to Specialist Info


The last 3 fields are for Multiline Entry fields

Other Info
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