Sample Patient Registration Form

The hospital management system has really taken a professional look. Everything has become more organized and well maintained in each and every respect. Good hospitals always make sure that the hospital environment is friendly and easily approachable for the patient. They are especially interested in attracting new patients so that more and more people can benefit from their patient care services.

The first step which should be made smooth and effortless is the registration of the patient. It can also be called as the booking of the patient especially if it is an obstetric patient.

It is most of the times mandatory for patients to fill out a form known as admission form that contains very basic information about the patients and medical history if any. This information includes the contact information of the patients, the payment guarantees, the designation of the party that is responsible for payment.

Registration of patient in a hospital and its importance

Patient’s registration at a hospital is the first and foremost step in patient care. Since hospital administration must be interested in providing the swift system of patient care; they are always in making the registration process easier and approachable.

Registration of the patient is important because at the time of registration, a patient is always given a medical record number and his necessary details are always kept as a record for the future reference.

Patient’s registration also provides the basic information of the patient, his insurance details and the situation of his ailments so that he can be sent to the proper service line in the hospital. This especially applies in a tertiary care hospital.

In the field of medical, patient registration refers to two different options. One option is related to the collection of data pertaining to new patients and involves the generation of patient record. The other option is related to the collection of information that is used in computer-assisted surgery which covers the accurate and detailed studies of medical imaging which are necessary to guide the computer safely and accurately in surgery.

Procedure for patient’s registration in the hospital

  1. The procedure is mostly simple and efficient in good and state of the art hospitals. Patients need to approach the registration counter which is labeled clearly and is mostly at the entrance of the hospital so that all the incoming patients can easily identify and approach them.
  2. Patient just mentions his interest in the hospital or he may tell that he has come for a consultation with a specific doctor. The person sitting at the registration desk then starts filling the registration form and asks certain basic questions. He may ask for your identity card and insurance details for the form.
  3. After he is done with the basic information, he may issue a card with a medical record number which is to be kept with the patient. He may direct you to the service line in which you intend to come where you are asked relevant history and basic examination is done.
  4. After that, a file is created in your name with your medical record number. You are now registered in the hospital as their patient and your file is kept in the hospital’s medical records department.
  5. Whenever you come for the next visit for a checkup, you simply need to get an appointment with your medical record number and card and then you can go to your respective service line for the checkup.

Patient’s registration forms

  1. Patient registration form as mentioned above contains the basic information of the patient which includes name, age, sex, date of birth, address, contact number, email address and insurance details.
  2. Sometimes, the basic medical and surgical history is mentioned after height, weight and other details.

The registration form also includes information regarding insurance billing, particularly if a patient is entitled to insurance coverage for health care expenses.

During the process of patient registration, patients will have to provide information about insurance cards. The form has to be completed in detail in every aspect and the patients should always ensure to update the information about medical history or contact details if there is any change at any time.

In case of emergency, sometimes a patient can undergo any required treatment without providing registration information, and any friend or family can fill the patient registration form and later the patient himself can verify the information and approve it.

Just in case the patient is alone and has no assistance and has no identity at the time of admission, the hospital or clinic can temporarily set up registration.

Here is a preview of sample patient registration form along with download options.

Sample Form-1

Sample Patient Registration Form


Sample Form-2

Patient registration form


Simi Karton

Dr. Simi Karton currently resides in Los Angeles with her husband. This website is a voluntary work of Dr. Karton to provide people with useful health-related information with a straightforward approach.

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