#{patientHome.managed ? 'Edit' : 'Add'} Patient
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.City']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Country']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.DateBirth']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Email']}
#{messages['users.FirstName']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Gender']}
#{messages['users.LastName']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Maidenname']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.PatientId']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Race']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Religion']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.State']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Street']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Telephone']}
#{messages['net.ihe.gazelle.simulator.PDQPDCSimulator.Zipcode']}
*
required fields