Just some comments.

Your Billing and Findings Tables must have a field with ConsultNo to link with the Consultation table. Change the relation according.

Probably you need to connect Medication to the Doctor and to the Pharmacy so you'll need the fileds for DoctorId and PharId in the Medications table and change the relations according.

On the Appointment table you'll refer also to the Nurse and to the Patient related to this appointment, so add the NurseId and PatId fileds to the appointment table and change the relations.

Probably you will add a relation between Lab_results and MedTech. Also you will need tohave the result values, and alslo the reference min/max values and the unit of mesure for the Lab_Results.

On the confinement table maybe you will know the patient, adding the PatId and setting the corresponding relation between Patient and Confinement.

Abut the OutPatient relation to the Patient defined 1 to 1 means that you never can creat a new patient, because you need an existing outpatient with the same ID, but you alse never can create an outpatiente because you need an existimg patient with the same Id. to solve this, you can add a OutPatient flag in the Patient table and forgot about the OutPatient table.

Hope this helps

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