diff --git a/pwa/src/components/PatientInfoForm.tsx b/pwa/src/components/PatientInfoForm.tsx
index 9530d4b..a2e424f 100644
--- a/pwa/src/components/PatientInfoForm.tsx
+++ b/pwa/src/components/PatientInfoForm.tsx
@@ -109,37 +109,38 @@ export default function Form(): ReactElement {
             'exam',
         ) as HTMLInputElement
         updateCentralState({
-            firstName: firstNameField.value,
-            lastName: lastNameField.value,
+            first_name: firstNameField.value,
+            last_name: lastNameField.value,
             nickname: nicknameField.value,
-            sex: sex ? SEX.female : SEX.male,
-            birthDate: new Date(birthdateField.value),
+            gender: sex ? SEX.female : SEX.male,
+            birthdate: new Date(birthdateField.value),
             age: parseInt(age.value),
             phone: phone.value,
             town: town.value,
-            firstVisit: firstVisit,
-            pregnant: pregnant,
-            G: sex ? parseInt(gravida.value) : null,
-            P: sex ? parseInt(para.value) : null,
-            A: sex ? parseInt(abortus.value) : null,
-            LMP: sex ? new Date(lmp.value) : null,
-            wantsPlanning: planning,
-            weight: parseFloat(weight.value),
-            height: parseFloat(height.value),
-            bloodPressure: bloodPressureValue,
-            temperature: parseFloat(temp.value),
-            pulse: parseFloat(pulse.value),
+            first_visit: firstVisit,
+            ob_pregnant: pregnant,
+            ob_gravida: sex ? parseInt(gravida.value) : null,
+            ob_para: sex ? parseInt(para.value) : null,
+            ob_abortus: sex ? parseInt(abortus.value) : null,
+            ob_last_menstrual_period: sex ? new Date(lmp.value) : null,
+            ob_wants_planning: planning,
+            weight_in_lbs: parseFloat(weight.value),
+            height_in_inches: parseFloat(height.value),
+            bp_systolic_blood_pressure: parseInt(
+                bloodPressureValue.split('/')[0],
+            ),
+            bp_diastolic_blood_pressure: parseInt(
+                bloodPressureValue.split('/')[1],
+            ),
+            temp_in_fahrenheit: parseFloat(temp.value),
+            pulse_rate: parseFloat(pulse.value),
             zScore: parseFloat(zScore.value),
-            albendazole: albendazole,
-            allergies: allergies.value,
-            medicines: medicines.value,
-            chiefComplaint: [
-                complaintField1.value,
-                complaintField2.value,
-                complaintField3.value,
-            ],
-            history: history.value,
-            exam: exam.value,
+            albendazole_given: albendazole,
+            known_med_allergies: allergies.value,
+            meds_currently_taken: medicines.value,
+            chief_complaint: `1.) ${complaintField1.value} 2.) ${complaintField2.value} 3.) ${complaintField3.value}`,
+            history_of_present_illness: history.value,
+            exam_comments: exam.value,
         })
     }
 
@@ -296,7 +297,7 @@ export default function Form(): ReactElement {
                 id="weight"
                 maxLength={3}
             >
-                Weight (kg)
+                Weight (lb)
             </InputItem>
 
             <InputItem
@@ -305,7 +306,7 @@ export default function Form(): ReactElement {
                 id="height"
                 maxLength={3}
             >
-                Height (cm)
+                Height (inch)
             </InputItem>
 
             <InputItem
diff --git a/pwa/src/scss/App.scss b/pwa/src/scss/App.scss
index 07cca34..43ca575 100644
--- a/pwa/src/scss/App.scss
+++ b/pwa/src/scss/App.scss
@@ -7,9 +7,9 @@
 }
 
 .am-input-label {
-  padding-right: 0.5em !important;
+    padding-right: 0.9em !important;
 }
 
 .am-textarea-label {
-  padding-right: 0.5em !important;
+    padding-right: 0.9em !important;
 }
diff --git a/pwa/src/state/models/patientInfoForm.model.ts b/pwa/src/state/models/patientInfoForm.model.ts
index e9aefd7..ce41ae4 100644
--- a/pwa/src/state/models/patientInfoForm.model.ts
+++ b/pwa/src/state/models/patientInfoForm.model.ts
@@ -2,33 +2,35 @@ import { Action, action } from 'easy-peasy'
 import { SEX, YN } from '../enums'
 
 interface PatientInfoFormFields {
-    firstName?: string
-    lastName?: string
+    first_name?: string
+    last_name?: string
     nickname?: string
-    sex?: SEX
-    birthDate?: Date
+    gender?: SEX
+    birthdate?: Date
     age?: number
     phone?: string
     town?: string
-    firstVisit?: YN
-    pregnant?: YN
-    G?: number
-    P?: number
-    A?: number
-    LMP?: Date
-    wantsPlanning?: YN
-    weight?: number
-    height?: number
-    bloodPressure?: string
-    temperature?: number
-    pulse?: number
+    first_visit?: YN
+    ob_pregnant?: YN
+    ob_gravida?: number
+    ob_para?: number
+    ob_abortus?: number
+    ob_last_menstrual_period?: Date
+    ob_wants_planning?: YN
+    weight_in_lbs?: number
+    height_in_inches?: number
+    bp_systolic_blood_pressure?: number
+    bp_diastolic_blood_pressure?: number
+    temp_in_fahrenheit?: number
+    pulse_rate?: number
+    // TODO: Can't find zScore proper name?
     zScore?: number
-    albendazole?: YN
-    allergies?: string
-    medicines?: string
-    chiefComplaint?: string[]
-    history?: string
-    exam?: string
+    albendazole_given?: YN
+    known_med_allergies?: string
+    meds_currently_taken?: string
+    chief_complaint?: string
+    history_of_present_illness?: string
+    exam_comments?: string
 }
 
 export interface PatientInfoFormModel {