Registration - CitraX Mini

Order Information & Staff on Duty

Standard Accession Number (Order ID) * Standard international order and MWL reference number (DICOM 0008,0050).

Radiographer / Registrar *

Patient Profile

ID / NRIC / Passport Number *

Patient record found. Details autofilled.

Full Name *

Age (Years) *

Sex *

Race / Ethnicity

Citizenship

Phone Number

Residential Address

Referral & Clinical Information

Referring Clinic *

Patient Mobility

Civil Servant

Ordering Physician / Medical Officer

Clinical Indication / Notes

Requested Examinations

Piawaian KKM PACS: Setiap bahagian pemeriksaan diberikan Accession Number unik tersendiri (1 Bahagian = 1 Accession No / Folder Kajian) pada konsol DICOM MWL.

Anatomical Part	Laterality	Modality	Media / Film	Notes	Action
					Primary

Print Referral Access Slip (QR Code & PIN) for Patient / External Facility

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