ASP.NET Core Web Register

I need a website that can serve as a registry for rabies virus bites and store the data on a database. The form must include the following: Personal Data: Name, Last name, 2nd last name, telephone, birthdate, age, sex, weight, residential address, postal address, exposure date, exposure address, exposure type (bite, scratch, other(specify)), provoked bite?(y/n), bite area, animal has owner?(y/n), owner telephone, owner residential address, owner postal address, animal description, person who takes info Medical data: institution type, name of health provider that runs the case, telephone, date case was attended, address, name of doctor who attended the case, license number (optional), name of nurse/epidemiologist who gathers info, treatment: (wound cleanse, antitoxin/ig antitetanic administration, other(specify) Animal data: type of animal (mongoose, dog, cat, horse, cow, other(specify), animal description(sex, color kind if applies), vaccinated against rabies virus? (y/n or unknown), vaccination date (include vaccination certificate attached), animal info from the owner? (y/n), does the health inspector finds the animal? (y/n), health inspector animal appreciation: (aggressive, good/bad motor coordination, eats and drinks water, does not eats nor drinks water, good/bad vocalization), comments from animal owner, health inspector conclusion (rabies symptoms, no rabies symptoms), stray animal was captured?(y/n, unknown), animal died? (y/n, unknown), death date, was animal sacrificed? (y/n, unknown), comments (justification), animal put on isolation? (10 days, 45 days, 4 months, 6 months(on vet clinic)), isolation start date, isolation end date, state of animal after observation period: (sane, sick, dead), rabies sample submitted? (y/n), health inspector who takes info Treatment info: profilaxis recommendation by epi. div.:(y/n), profilaxis start date (if any), rig start date (if any), hdcv 1st dose start date (if any), hdcv 2nd dose start date (if any), hdcv 3rd dose start date (if any), hdcv 4th dose start date (if any), profilaxis completed? (y/n), date Lab info: species number, hometown, date received, species (mammal), origin, fluorescent rabies antibody:(negative, positive, denied), results date, signature, additional comments All data must be available for all 5 groups real time.