Voric
Proposal
Patient Medical Form - Web Application
Occupational Health Management Platform
Prepared by
Code Uncode
Date
25 March 2026
A web application for Voric that digitises patient medical
forms with a split-fill workflow — patients complete their demographics, history, and symptoms, then hand off to
medical professionals via QR code to complete examination, diagnosis, and advice. The platform will support
offline use, multi-role access, and analytics over collected health data.
Scope
-
Patient Form (Sections 1-3)
— Demographics, vitals, past history, and current symptoms with Y/N toggles, duration fields, and medication/remarks inputs
-
QR Code Handover
— On submit, patient's sections lock and a unique token + QR code is generated for the medical professional to scan
-
Medical Professional Auth
— Session-based email/password login so professionals authenticate once and process multiple patients
-
Doctor Form (Sections 4-6)
— Examination (GRBS, Mallampati, spirometry), diagnosis, and advice fields pre-filled with patient context
-
Database + API
— Cloudflare D1 schema and API routes for form creation, retrieval, and updates
-
Responsive Design
— Mobile-first layout optimised for patients on phones and professionals on tablets/desktops
-
PWA Setup
— Service worker, install prompt, and app manifest so the app can be installed on any device
-
Offline Form Filling
— IndexedDB-backed local storage so forms can be filled without internet connectivity
-
Background Sync
— Queued submissions are automatically sent when connectivity is restored
-
Patient History
— Search and retrieve past forms by patient name or clinic ID
-
Form Listing
— Filterable list of forms for medical professionals with status and date filters
Technical Architecture
| Framework |
Remix + TypeScript |
| Styling |
Tailwind CSS + shadcn/ui |
| Database |
Cloudflare D1 |
| ORM |
Drizzle ORM |
| Sessions |
Cloudflare KV |
| Hosting |
Cloudflare Pages + Workers |
Recurring Costs
| Item |
Cost |
Notes |
| Cloudflare Workers (Paid) |
₹500/mo |
Workers, Pages, D1, KV, and Queues |
This proposal is valid for 30 days from the date of issue. Costs are exclusive of applicable taxes. Final scope
and pricing may be revised based on discussions.