Register Patient (Backend API)

Temporary form to send patient profile to Laravel API.

Full Name *

Patient Email

Password

If email and password are provided, a patient login will be created.

Age

BMI

HLA Typing (comma separated)

Crossmatch Result

Sex

Blood Group

Rh Factor

PRA Score

Current Creatinine

GFR

Urea

Diagnosis

Urgent Level

DSA

HIV Status

HBV Status

HCV Status

Diabetes

Hypertension

Rejection History

Previous Transplant

Enter height and weight to auto-fill BMI.

Height (cm)

Weight (kg)

Computed BMI

—

This value is automatically applied to the BMI field.

Helpful reference for key transplant and nephrology terms.

BMI (Body Mass Index)
Measures body fat based on height and weight.
HLA Typing
Identifies genetic markers to check immune compatibility between donor and patient.
Crossmatch Result
Test showing if the patient’s antibodies react against the donor’s cells.
Rh Factor
Protein in blood (+ or –) that affects blood compatibility.
PRA Score (Panel Reactive Antibody)
Percentage showing how likely a patient is to reject a donor kidney.
Current Creatinine
Blood test that shows how well the kidneys are working.
GFR (Glomerular Filtration Rate)
Estimates how efficiently the kidneys filter blood.
Urea
Waste product measured to assess kidney function.
DSA (Donor-Specific Antibody)
Antibodies in the patient’s blood that target a specific donor’s tissue.
HIV Status
Indicates if the person is positive or negative for HIV infection.
HBV Status
Indicates if the person has Hepatitis B infection.
HCV Status
Indicates if the person has Hepatitis C infection.
Diabetes
A condition where blood sugar levels are too high.
Hypertension
High blood pressure that can damage the kidneys.
Rejection History
Record of whether the patient’s body has previously rejected a transplanted organ.
Previous Transplant
Notes if the patient has already received a transplant before.