Personal Information
{{isset($patient->name_prefix) ? $patient->name_prefix : 'None' }}
	Male Female Other

Emergency contact

@if( isset( $patient->refferal ) ) @endif

Referral source
How did you hear about this clinic?

@if(isset($practitionerIntakeForm) && $practitionerIntakeForm->health_history == 1) @if( isset( $practitionerDisease ) ) @foreach( $practitionerDisease as $key => $disease ) @foreach( $disease as $ke => $val )

Health History

If you have a history of any of the following conditions, please select below.