Personal Information
Name
John Doe
Age
21
Gender
Male
Phone Number
0000000000
Blood Group:
000000000
Address
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Pincode:
XXYYZZ

Medical Information

Height:

160

Weight:

80

Blood Group:

A+

Diabetic/Pre-Diabetic

No

Allergies

Peanuts

Preferences

Emergency Contact Name:

Alan Grace

Emergency Contact Number:

000000000

Nearest Hospital Radius:

15 Kms

Nearest Hospital Radius:

15 Kms