Custom application to cature data

I need a desktop application that will allow me to capture the following fields: 1. Company Name: (Text Field) 2. Contact: (Text Field) 3. Phone Number 1: (Number Field) (Masked if possible) 4. Phone Number 2: (Number Field) (Masked if possible) 5. Cell Phone: (Number Field) (Masked if possible) 6. Fax: (Number Field) (Masked if possible) 7. Email: (Text Field) (Masked if possibly) 8. Address 1:(Text Field) 9. Address 2:(Text Field) 10. City:(Text Field) 11. State:(Text Field) (Two characters only) 12. Zip: (Number Field) (5 characters only) 13. Notes: (Memo Field, Long text) 14. I need a field that will allow me to draw (sort of like MS Paint). I will be drawing using a stylus on a tablet or a mouse on a none touch desktop computer. If only one option is available I will select the tablet functionality versus the desktop functionality. I need to be able to add "stamps" to the drawing. My definition of a stamp: Being able to add a preloaded icon size image to a drawing area. I would pre-load the stamps in the setup part of the app. I can also add/ import an image from anywhere on the tablet, i.e. my documents, my pictures... 15. Capture pictures from the on-board camera. I can take as many pictures as I want. When the pictures are exported to the report a letter size page should fit 4 pictures. 16. Signature capture from the stylus. I need to be able to capture a signature using the tablet. The person signing will use the tablets stylus to sign in a designated area. Once the data is captured we need to be able to export the data. We can either: save, print or email it. The data will be stored in a SQL db for later retrieval. I prefer MySQL, but something lighter and flexible will do as well. I can look up past transactions by company field or contact field or any of the phone numbers provided. The app will have to run in several environments: Win XP, Win Vista and Win 7. Win 8 if possible. The app needs to be tablet friendly (tablet running previous mentioned versions of Windows.) By tablet friendly I mean it needs to had larger than normal fields so it is easier to use my finger to select the field and the app needs to accept in put in the hand writing recognition utility that MS includes on Windows.