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DNA Patient Data Input Form
RSC Patient ID
Barcode
Date of birth
Gender
Female
Male
Height in...
Select Height in...
Metric (cm)
Imperial (ft & in)
Height
Height
Height
Weight
Select Weight type
Kg
lbs
Stone
Kg
lbs
Stone
lbs
Select Waist in
Select Waist in
cm
Inches
Waist cm
Waist inch
Select Hip in
Select Hip in
cm
Inches
Hip cm
Hip inch
Physically Active
Yes
No
Veggies
Every day
Not every day
Blood Pressure meds
No
Yes
Blood Glucose
No
Yes
Family with Diabetes
No
Aunt etc
Parent etc
Submit
