The image shows a Create External Customer screen, consists of Customer Number, Customer Name, Short Name, Customer Type, Source Customer ID, Source System, Customer Category and Relationship Manager ID fields.

A Address section consists of Address Line 1, Address Line 2, Address Line 3, Address Line 4, Country and Postal Code fields.

A Other Details section consists of Deceased, Frozen, Whereabouts Unknown, Sanction Check Required, Walk-in Customer, Staff, Language and Nationality toggle fields.

A Save and Cancel button at the bottom.