Doctor Name: {{ $doctorName ?? '—' }}
HIGH RISK CONSENT
Patient Name: {{ $patient->full_name }}
(Age): {{ $patient->age ?? '—' }}
UHID: {{ $patient->uhid ?? '—' }}
Phone: {{ $patient->phone ?? '—' }}

The doctor has clearly explained to us that during the treatment/procedure for our patient {{ $patient->full_name }}, there is a possibility of serious complications and life risk. We have understood this and we are giving this consent voluntarily.

If any unexpected complication, risk, or life-threatening situation occurs during the treatment, we agree that we will not hold the doctor, hospital staff, or hospital management responsible, and we will not claim any compensation.

We are signing this consent after understanding the above.

Signature / Thumb Impression
Relationship with Patient
Name:
Mobile: