diff --git a/erpnext/healthcare/doctype/patient_appointment/patient_appointment.py b/erpnext/healthcare/doctype/patient_appointment/patient_appointment.py
index e15cad8056b..c867120bc8a 100755
--- a/erpnext/healthcare/doctype/patient_appointment/patient_appointment.py
+++ b/erpnext/healthcare/doctype/patient_appointment/patient_appointment.py
@@ -134,7 +134,8 @@ def invoice_appointment(appointment_doc):
 		payment.amount = appointment_doc.paid_amount
 
 		sales_invoice.set_missing_values(for_validate=True)
-		sales_invoice.save(ignore_permissions=True, ignore_mandatory=True)
+		sales_invoice.flags.ignore_mandatory = True
+		sales_invoice.save(ignore_permissions=True)
 		sales_invoice.submit()
 		frappe.msgprint(_('Sales Invoice {0} created as paid'.format(sales_invoice.name)), alert=True)
 		frappe.db.set_value('Patient Appointment', appointment_doc.name, 'invoiced', 1)
diff --git a/erpnext/healthcare/doctype/vital_signs/vital_signs.py b/erpnext/healthcare/doctype/vital_signs/vital_signs.py
index 2ab2fdb35c6..959e8504c47 100644
--- a/erpnext/healthcare/doctype/vital_signs/vital_signs.py
+++ b/erpnext/healthcare/doctype/vital_signs/vital_signs.py
@@ -25,7 +25,8 @@ def insert_vital_signs_to_medical_record(doc):
 	medical_record.reference_doctype = 'Vital Signs'
 	medical_record.reference_name = doc.name
 	medical_record.reference_owner = doc.owner
-	medical_record.save(ignore_permissions=True, ignore_mandatory=True)
+	medical_record.flags.ignore_mandatory = True
+	medical_record.save(ignore_permissions=True)
 
 def delete_vital_signs_from_medical_record(doc):
 	medical_record = frappe.db.get_value('Patient Medical Record', {'reference_name': doc.name})