```html @php $portal = 'STAFF PORTAL'; $rolePath = 'staff'; @endphp Add Dependent

PKU Dental

UPSI

{{ $portal }}

⌂ Dashboard ▣ Book Appointment ▤ Dependents ▤ My Appointments ◉ Live Queue ♙ Walk-In ☷ History ☎ Contact PKU ▣ Dental Services 💳 Allocation ○ Profile ⇥ Logout

Add Dependent

{{ now()->format('D, d M Y') }}

Register New Dependent

Add spouse or child under your allocation.

@csrf

Full Name

IC Number

Date of Birth

Relationship

Gender

Phone Number

```