Inspection Form Development with Backend

I'm looking for a proof of concept to develop an inspection form that can be used on both web and mobile platforms. The form should capture the following details:

- Deficiencies with pictures attached to specific items
- Drop-down selections for various categories

The information should flow into a backend system for easy management and review.

Ideal skills and experience:
- Experience in form development for both web and mobile platforms
- Strong backend development skills
- Ability to integrate image uploads with form inputs
- Familiarity with database management and data flow

Please provide samples of similar work done.