diff --git a/src/app/merms-managepatient/merms-managepatient.page.html b/src/app/merms-managepatient/merms-managepatient.page.html
index a49b954..c3d2252 100644
--- a/src/app/merms-managepatient/merms-managepatient.page.html
+++ b/src/app/merms-managepatient/merms-managepatient.page.html
@@ -25,12 +25,32 @@
         <ion-col>
           <ion-icon name="person-add-outline" style="padding-right: 20px; padding-left: 20px;"></ion-icon>
         </ion-col>
+
+
       </ion-row>
       <ion-row>
         <ion-list style="width: 100%;">
           <ion-item> 
             This is the add + edit patient engine point 
           </ion-item>
+
+          <ion-item> 
+            This is the selected patient
+           </ion-item>
+ 
+           <ion-item>
+            <ion-label position="stacked">Basic Information</ion-label>
+            <ion-input placeholder="Firstname"></ion-input>
+            <ion-input placeholder="Lastname"></ion-input>
+
+             <ion-label position="stacked">Address</ion-label>
+             <ion-input placeholder="Address Line 1"></ion-input>
+             <ion-input placeholder="Address Line 2"></ion-input>
+             <ion-input placeholder="City"></ion-input>
+             <ion-input placeholder="State"></ion-input>
+             <ion-input placeholder="Zip Code"></ion-input>
+           </ion-item>
+
         </ion-list>
       </ion-row>
     </ion-grid>