Convert simple 2 page document to Electronic Form for ipad - repost

We need a 2 page black and white document converted to a electronic form for use on an Ipad and Android for a concept. There are a number of questions on the form that will need the ability to be able to be filled in. Also need a front and back image of a small person that has the ability to be able to click on an area of the body to place a small red cross onto. This needs to be very easy to navigate and look professional for concept presentation. Further development work after stage 1 is approved. Please send similar examples of work that you have completed. Will only consider applicants who can demonstrate previous experience and working examples. Do not apply unless you have previous working examples to review.