diff --git a/erpnext/healthcare/doctype/consultation/consultation.py b/erpnext/healthcare/doctype/consultation/consultation.py
index 69d7ecb..ebf80d6 100755
--- a/erpnext/healthcare/doctype/consultation/consultation.py
+++ b/erpnext/healthcare/doctype/consultation/consultation.py
@@ -113,9 +113,11 @@
 
 def update_consultation_to_medical_record(consultation):
 	medical_record_id = frappe.db.sql("select name from `tabPatient Medical Record` where reference_name=%s", (consultation.name))
-	if(medical_record_id[0][0]):
+	if medical_record_id and medical_record_id[0][0]:
 		subject = set_subject_field(consultation)
 		frappe.db.set_value("Patient Medical Record", medical_record_id[0][0], "subject", subject)
+	else:
+		insert_consultation_to_medical_record(consultation)
 
 def delete_medical_record(consultation):
 	frappe.db.sql("""delete from `tabPatient Medical Record` where reference_name = %s""", (consultation.name))
diff --git a/erpnext/healthcare/doctype/lab_test/lab_test.py b/erpnext/healthcare/doctype/lab_test/lab_test.py
index 6fd9535..3ad8b53 100644
--- a/erpnext/healthcare/doctype/lab_test/lab_test.py
+++ b/erpnext/healthcare/doctype/lab_test/lab_test.py
@@ -244,7 +244,7 @@
 def delete_lab_test_from_medical_record(self):
 	medical_record_id = frappe.db.sql("select name from `tabPatient Medical Record` where reference_name=%s",(self.name))
 
-	if(medical_record_id[0][0]):
+	if medical_record_id and medical_record_id[0][0]:
 		frappe.delete_doc("Patient Medical Record", medical_record_id[0][0])
 
 def create_item_line(test_code, sales_invoice):
diff --git a/erpnext/healthcare/doctype/vital_signs/vital_signs.py b/erpnext/healthcare/doctype/vital_signs/vital_signs.py
index 436f79f..dea848d 100644
--- a/erpnext/healthcare/doctype/vital_signs/vital_signs.py
+++ b/erpnext/healthcare/doctype/vital_signs/vital_signs.py
@@ -27,7 +27,7 @@
 
 def delete_vital_signs_from_medical_record(doc):
 	medical_record_id = frappe.db.sql("select name from `tabPatient Medical Record` where reference_name=%s",(doc.name))
-	if(medical_record_id[0][0]):
+	if medical_record_id and medical_record_id[0][0]:
 		frappe.delete_doc("Patient Medical Record", medical_record_id[0][0])
 
 def set_subject_field(doc):