ZainCare Health Screening · Clinical Test Bench

Encounter & Screening Inputs Ready

1. Participant & Encounter Demographics

Participant Name

Report ID / Accession

Age (Years)

Sex at Birth

👩 Female

👨 Male

Date of Screening

Screening Location & Camp

Licensed Provider Name

Screening Reviewed By (Clinician)

Reviewer License Number

Screening Operator (Nurse/Tech)

Operator Designation

Consent to receive this report by WhatsApp

2. Blood Pressure, Pulse & AFib Screening (Single vs Series)

BP Measurement Mode

Pulse Rate (bpm)

Reading 1 (mmHg)

Reading 2 (mmHg)

Reading 3 (mmHg)

Systolic BP (mmHg)

Diastolic BP (mmHg)

AFib Screening Signal (Monitor)

BP Monitor Model

Readings in Series

Arm Used

Repeat performed

3. Blood Glucose Screening (Capillary POC)

Glucose (mg/dL)

Meal Context

Fasting Duration (Hours)

Testing Method

Glucometer Model

4. Anthropometrics: BMI & Central Adiposity (WHtR)

Weight (kg)

Height (cm)

Waist Circumference (cm)

Pregnant, significant ascites, or major abdominal distension (suppresses WHtR interpretation)

5. Structured Symptoms Check (Red-Flag Triggers)

None reported

Palpitations

Dizziness

Fainting / Near-fainting

Chest Pain

Breathlessness

Weakness / Numbness

Speech / Vision change

6. Examiner Observation & Sign-Off

Clinical Observation (Leave empty to auto-generate)

✓ Examiner has reviewed and approves final observation

Live 4-Page Screening Report Preview