FA

**GENERAL**
**Body Weight:**  [text name="variable_1" default=""]lbs
**Temperature:**   [text name="variable_2" default=""]*F
**Pulse / HR:**   [text name="variable_3" default=""]/ min
**Resp. Rate:**    [text name="variable_4" default=""]/ min
**Ruminations:**    [text name="variable_5" default=""]/ 2 min
**Body Condition:**  [text name="variable_6" default=""]/9
**Mental Status:**  [text name="variable_7" default=""]
**Posture:**  [text name="variable_8" default=""]
**Gait / Strength:**  [text name="variable_9" default=""]
[checkbox name="conformation" value="**Conformation:**"]   [text name="variable_10" default=""]
[checkbox memo="Head and Neck" memo_size="large" name="h1" value=""]
[conditional field="h1" condition="(h1).is('')"]**HEAD/NECK**
[select memo="Facial Symmetry
" name="facial_sym" value="|**Facial Symmetry:** Normal
|**Facial Symmetry:** Abnormal"][/conditional][conditional field="facial_sym" condition="(facial_sym).is('**Facial Symmetry:** Abnormal')"]: [text name="abn_facial_sym" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Sclera
" name="sclera" value="|**Sclera:** Normal
|**Sclera:** Abnormal"][/conditional][conditional field="sclera" condition="(sclera).is('**Sclera:** Abnormal')"]: [text name="abn_sclera" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Vision
" name="vision" value="|**Vision:** Normal
|**Vision:** Abnormal"][/conditional][conditional field="vision" condition="(vision).is('**Vision:** Abnormal')"]: [text name="abn_vision" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Hydration
" name="hydration" value="|**Hydration:** Normal
|**Hydration:** Abnormal"][/conditional][conditional field="hydration" condition="(hydration).is('**Hydration:** Abnormal')"]: [text name="abn_hydration" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Nares
" name="nares" value="|**Nares:** Normal
|**Nares:** Abnormal"][/conditional][conditional field="nares" condition="(nares).is('**Nares:** Abnormal')"]: [text name="abn_nares" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Dentition
" name="dentition" value="|**Dentition:** Normal
|**Dentition:** Abnormal"][/conditional][conditional field="dentition" condition="(dentition).is('**Dentition:** Abnormal')"]: [text name="abn_dentition" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Capillary Refill
" name="cap_refill" value="|**Capillary Refill:** Normal
|**Capillary Refill:** Abnormal"][/conditional][conditional field="cap_refill" condition="(cap_refill).is('**Capillary Refill:** Abnormal')"]: [text name="abn_cap_refill" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Oral MM
" name="oral" value="|**Oral MM:** Normal
|**Oral MM:** Abnormal"][/conditional][conditional field="oral" condition="(oral).is('**Oral MM:** Abnormal')"]: [text name="abn_oral" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Tongue
" name="tongue" value="|**Tongue:** Normal
|**Tongue:** Abnormal"][/conditional][conditional field="tongue" condition="(tongue).is('**Tongue:** Abnormal')"]: [text name="abn_tongue" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Mandible
" name="mandible" value="|**Mandible:** Normal
|**Mandible:** Abnormal"][/conditional][conditional field="mandible" condition="(mandible).is('**Mandible:** Abnormal')"]: [text name="abn_mandible" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Mandibular LN
" name="mandibular_ln" value="|**Mandibular LN:** Normal
|**Mandibular LN:** Abnormal"][/conditional][conditional field="mandibular_ln" condition="(mandibular_ln).is('**Mandibular LN:** Abnormal')"]: [text name="abn_mandibular_ln" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Prescapular LN
" name="prescapular_ln" value="|**Prescapular LN:** Normal
|**Prescapular LN:** Abnormal"][/conditional][conditional field="prescapular_ln" condition="(prescapular_ln).is('**Prescapular LN:** Abnormal')"]: [text name="abn_prescapular_ln" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Jugular Veins
" name="jugular_veins" value="|**Jugular Veins:** Normal
|**Jugular Veins:** Abnormal"][/conditional][conditional field="jugular_veins" condition="(jugular_veins).is('**Jugular Veins:** Abnormal')"]: [text name="abn_jugular_veins" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][select memo="Briscket
" name="brisket" value="|**Brisket:** Normal
|**Brisket:** Abnormal"][/conditional][conditional field="brisket" condition="(brisket).is('**Brisket:** Abnormal')"]: [text name="abn_brisket" default=""]
[/conditional][conditional field="h1" condition="(h1).is('')"][checkbox memo="Thorax" memo_size="large" name="h2" value=""]
[conditional field="h2" condition="(h2).is('')"]**THORAX**
[select memo="Heart Rhythm
" name="heart_rhythm" value="|**Heart Rhythm:** Normal
|**Heart Rhythm:** Abnormal"][/conditional][conditional field="heart_rhythm" condition="(heart_rhythm).is('**Heart Rhythm:** Abnormal')"]: [text name="abn_heart_rhythm" default=""]
[/conditional][conditional field="h2" condition="(h2).is('')"][select memo="Intensity
" name="intensity" value="|**Intensity:** Normal
|**Intensity:** Abnormal"][/conditional][conditional field="intensity" condition="(intensity).is('**Intensity:** Abnormal')"]: [text name="abn_intensity" default=""]
[/conditional][conditional field="h2" condition="(h2).is('')"][select memo="Murmurs
" name="murmurs" value="|**Murmurs:** Normal
|**Murmurs:** Abnormal"][/conditional][conditional field="murmurs" condition="(murmurs).is('**Murmurs:** Abnormal')"]: [text name="abn_murmurs" default=""]
[/conditional][conditional field="h2" condition="(h2).is('')"][select memo="Pulse Character
" name="pulse_char" value="|**Pulse Character:** Normal
|**Pulse Character:** Abnormal"][/conditional][conditional field="pulse_char" condition="(pulse_char).is('**Pulse Character:** Abnormal')"]: [text name="abn_pulse_char" default=""]
[/conditional][conditional field="h2" condition="(h2).is('')"][select memo="Trachea
" name="trachea" value="|**Trachea:** Normal
|**Trachea:** Abnormal"][/conditional][conditional field="trachea" condition="(trachea).is('**Trachea:** Abnormal')"]: [text name="abn_trachea" default=""]
[/conditional][conditional field="h2" condition="(h2).is('')"][select memo="Lungs-R
" name="lungs_r" value="|**Lungs-R:** Normal
|**Lungs-R:** Abnormal"][/conditional][conditional field="lungs_r" condition="(lungs_r).is('**Lungs-R:** Abnormal')"]: [text name="abn_lungs_r" default=""]
[/conditional][conditional field="h2" condition="(h2).is('')"][select memo="Lungs-L
" name="lungs_l" value="|**Lungs-L:** Normal
|**Lungs-L:** Abnormal"][/conditional][conditional field="lungs_l" condition="(lungs_l).is('**Lungs-L:** Abnormal')"]: [text name="abn_lungs_l" default=""]
[/conditional][conditional field="h2" condition="(h2).is('')"][select memo="Resp Pattern
" name="resp_pat" value="|**Resp Pattern:** Normal
|**Resp Pattern:** Abnormal"][/conditional][conditional field="resp_pat" condition="(resp_pat).is('**Resp Pattern:** Abnormal')"]: [text name="abn_resp_pat" default=""]
[/conditional][checkbox memo="Limbs-Left-Front" memo_size="large" name="h3" value=""]
[conditional field="h3" condition="(h3).is('')"]**LIMBS-Left-Front**
[/conditional][conditional field="h3" condition="(h3).is('')"][select memo="Musculature
" name="musc_lf" value="|**Musculature:** Normal
|**Musculature:** Abnormal"][/conditional][conditional field="musc_lf" condition="(musc_lf).is('**Musculature:** Abnormal')"]: [text name="abn_musc_lf" default=""]
[/conditional][conditional field="h3" condition="(h3).is('')"][select memo="Joints
" name="joints_lf" value="|**Joints:** Normal
|**Joints:** Abnormal"][/conditional][conditional field="joints_lf" condition="(joints_lf).is('**Joints:** Abnormal')"]: [text name="abn_joints_lf" default=""]
[/conditional][conditional field="h3" condition="(h3).is('')"][select memo="Hooves
" name="hooves_lf" value="|**Hooves:** Normal
|**Hooves:** Abnormal"][/conditional][conditional field="hooves_lf" condition="(hooves_lf).is('**Hooves:** Abnormal')"]: [text name="abn_hooves_lf" default=""]
[/conditional][checkbox memo="Limbs-Left-Hind" memo_size="large" name="h3_b" value=""]
[conditional field="h3_b" condition="(h3_b).is('')"]**LIMBS-Left-Hind**
[/conditional][conditional field="h3_b" condition="(h3_b).is('')"][select memo="Musculature
" name="musc_lh" value="|**Musculature:** Normal
|**Musculature:** Abnormal"][/conditional][conditional field="musc_lh" condition="(musc_lh).is('**Musculature:** Abnormal')"]: [text name="abn_musc_lh" default=""]
[/conditional][conditional field="h3_b" condition="(h3_b).is('')"][select memo="Joints
" name="joints_lh" value="|**Joints:** Normal
|**Joints:** Abnormal"][/conditional][conditional field="joints_lh" condition="(joints_lh).is('**Joints:** Abnormal')"]: [text name="abn_joints_lh" default=""]
[/conditional][conditional field="h3_b" condition="(h3_b).is('')"][select memo="Hooves
" name="hooves_lh" value="|**Hooves:** Normal
|**Hooves:** Abnormal"][/conditional][conditional field="hooves_lh" condition="(hooves_lh).is('**Hooves:** Abnormal')"]: [text name="abn_hooves_lh" default=""]
[/conditional][checkbox memo="Limbs-Right-Front" memo_size="large" name="h4" value=""]
[conditional field="h4" condition="(h4).is('')"]**LIMBS-Right-Front**
[/conditional][conditional field="h4" condition="(h4).is('')"][select memo="Musculature
" name="musc_rf" value="|**Musculature:** Normal
|**Musculature:** Abnormal"][/conditional][conditional field="musc_rf" condition="(musc_rf).is('**Musculature:** Abnormal')"]: [text name="abn_musc_rf" default=""]
[/conditional][conditional field="h4" condition="(h4).is('')"][select memo="Joints
" name="joints_rf" value="|**Joints:** Normal
|**Joints:** Abnormal"][/conditional][conditional field="joints_rf" condition="(joints_rf).is('**Joints:** Abnormal')"]: [text name="abn_joints_rf" default=""]
[/conditional][conditional field="h4" condition="(h4).is('')"][select memo="Hooves
" name="hooves_rf" value="|**Hooves:** Normal
|**Hooves:** Abnormal"][/conditional][conditional field="hooves_rf" condition="(hooves_rf).is('**Hooves:** Abnormal')"]: [text name="abn_hooves_rf" default=""]
[/conditional][checkbox memo="Limbs-Right-Hind" memo_size="large" name="h4_b" value=""]
[conditional field="h4_b" condition="(h4_b).is('')"]**LIMBS-Right-Hind**
[/conditional][conditional field="h4_b" condition="(h4_b).is('')"][select memo="Musculature
" name="musc_rh" value="|**Musculature:** Normal
|**Musculature:** Abnormal"][/conditional][conditional field="musc_rh" condition="(musc_rh).is('**Musculature:** Abnormal')"]: [text name="abn_musc_rh" default=""]
[/conditional][conditional field="h4_b" condition="(h4_b).is('')"][select memo="Joints
" name="joints_rh" value="|**Joints:** Normal
|**Joints:** Abnormal"][/conditional][conditional field="joints_rh" condition="(joints_rh).is('**Joints:** Abnormal')"]: [text name="abn_joints_rh" default=""]
[/conditional][conditional field="h4_b" condition="(h4_b).is('')"][select memo="Hooves
" name="hooves_rh" value="|**Hooves:** Normal
|**Hooves:** Abnormal"][/conditional][conditional field="hooves_rh" condition="(hooves_rh).is('**Hooves:** Abnormal')"]: [text name="abn_hooves_rh" default=""]
[/conditional][checkbox memo="Abdomen-Left" memo_size="large" name="h5" value=""]
[conditional field="h5" condition="(h5).is('')"]**ABDOMEN-Left**
[/conditional][conditional field="h5" condition="(h5).is('')"][select memo="Contour
" name="contour" value="|**Contour:** Normal
|**Contour:** Abnormal"][/conditional][conditional field="contour" condition="(contour).is('**Contour:** Abnormal')"]: [text name="abn_contour" default=""]
[/conditional][conditional field="h5" condition="(h5).is('')"][select memo="Rumen Strata
" name="rumen" value="|**Rumen Strata:** Normal
|**Rumen Strata:** Abnormal"][/conditional][conditional field="rumen" condition="(rumen).is('**Rumen Strata:** Abnormal')"]: [text name="abn_rumen" default=""]
[/conditional][conditional field="h5" condition="(h5).is('')"][select memo="Percussion
" name="percussion_l" value="|**Percussion:** Normal
|**Percussion:** Abnormal"][/conditional][conditional field="percussion_l" condition="(percussion_l).is('**Percussion:** Abnormal')"]: [text name="abn_percussion_l" default=""]
[/conditional][conditional field="h5" condition="(h5).is('')"][select memo="Succussion
" name="succ_l" value="|**Succussion:** Normal
|**Succussion:** Abnormal"][/conditional][conditional field="succ_l" condition="(succ_l).is('**Succussion:** Abnormal')"]: [text name="abn_succ_l" default=""]
[/conditional][conditional field="h5" condition="(h5).is('')"][select memo="Prefemoral LN
" name="pf_l" value="|**Prefemoral LN:** Normal
|**Preformal LN:** Abnormal"][/conditional][conditional field="pf_l" condition="(pf_l).is('**Preformal LN:** Abnormal')"]: [text name="abn_pf_l" default=""]
[/conditional][checkbox memo="Abdomen-Right" memo_size="large" name="h6" value=""]
[conditional field="h6" condition="(h6).is('')"]**ABDOMEN-Right**
[/conditional][conditional field="h6" condition="(h6).is('')"][select memo="Percussion
" name="percussion_r" value="|**Percussion:** Normal
|**Percussion:** Abnormal"][/conditional][conditional field="percussion_r" condition="(percussion_r).is('**Percussion:** Abnormal')"]: [text name="abn_percussion_r" default=""]
[/conditional][conditional field="h6" condition="(h6).is('')"][select memo="Succussion
" name="succ_r" value="|**Succussion:** Normal
|**Succussion:** Abnormal"][/conditional][conditional field="succ_r" condition="(succ_r).is('**Succussion:** Abnormal')"]: [text name="abn_succ_r" default=""]
[/conditional][conditional field="h6" condition="(h6).is('')"][select memo="Ballotement
" name="ball" value="|**Ballotement:** Normal
|**Ballotement:** Abnormal"][/conditional][conditional field="ball" condition="(ball).is('**Ballotement:** Abnormal')"]: [text name="abn_ball" default=""]
[/conditional][conditional field="h6" condition="(h6).is('')"][select memo="Grunt Test
" name="grunt" value="|**Grunt Test:** Normal
|**Grunt Test:** Abnormal"][/conditional][conditional field="grunt" condition="(grunt).is('**Grunt Test:** Abnormal')"]: [text name="abn_grunt" default=""]
[/conditional][conditional field="h6" condition="(h6).is('')"][select memo="Umbilicus
" name="umb" value="|**Umbilicus:** Normal
|**Umbilicus:** Abnormal"][/conditional][conditional field="umb" condition="(umb).is('**Umbilicus:** Abnormal')"]: [text name="abn_umb" default=""]
[/conditional][conditional field="h6" condition="(h6).is('')"][select memo="Prefemoral LN
" name="pf_r" value="|**Prefemoral LN:** Normal
|**Prefemoral LN:** Abnormal"][/conditional][conditional field="pf_r" condition="(pf_r).is('**Prefemoral LN:** Abnormal')"]: [text name="abn_pf_r" default=""]
[/conditional][checkbox memo="Perineum" memo_size="large" name="h7" value=""]
[conditional field="h7" condition="(h7).is('')"]**PERINEUM**
[/conditional][conditional field="h7" condition="(h7).is('')"][select memo="Vulvar MM
" name="vulvar" value="|**Vulvar MM:** Normal
|**Vulvar MM:** Abnormal"][/conditional][conditional field="vulvar" condition="(vulvar).is('**Vulvar MM:** Abnormal')"]: [text name="abn_vulvar" default=""]
[/conditional][conditional field="h7" condition="(h7).is('')"][select memo="discharge
" name="discharge" value="|**Discharge:** Normal
|**Discharge:** Abnormal"][/conditional][conditional field="discharge" condition="(discharge).is('**Discharge:** Abnormal')"]: [text name="abn_discharge" default=""]
[/conditional][conditional field="h7" condition="(h7).is('')"][select memo="Feces
" name="feces" value="|**Feces:** Normal
|**Feces:** Abnormal"][/conditional][conditional field="feces" condition="(feces).is('**Feces:** Abnormal')"]: [text name="abn_feces" default=""]
[/conditional][conditional field="h7" condition="(h7).is('')"][select memo="Scrotum
" name="scrotum" value="|**Scrotum:** Normal
|**Scrotum:** Abnormal"][/conditional][conditional field="scrotum" condition="(scrotum).is('**Scrotum:** Abnormal')"]: [text name="abn_scrotum" default=""]
[/conditional][conditional field="h7" condition="(h7).is('')"][select memo="Sheath
" name="sheath" value="|**Sheath:** Normal
|**Sheath:** Abnormal"][/conditional][conditional field="sheath" condition="(sheath).is('**Sheath:** Abnormal')"]: [text name="abn_sheath" default=""]
[/conditional][conditional field="h7" condition="(h7).is('')"][select memo="Urine
" name="urine" value="|**Urine:** Normal
|**Urine:** Abnormal"][/conditional][conditional field="urine" condition="(urine).is('**Urine:** Abnormal')"]: [text name="abn_urine" default=""]
[/conditional][checkbox memo="Integument" memo_size="large" name="h8" value=""]
[conditional field="h8" condition="(h8).is('')"]**INTEGUMENT**
[/conditional][conditional field="h8" condition="(h8).is('')"][select memo="Hair Fiber
" name="hair" value="|**Hair Fiber:** Normal
|**Hair Fiber:** Abnormal"][/conditional][conditional field="hair" condition="(hair).is('**Hair Fiber:** Abnormal')"]: [text name="abn_hair" default=""]
[/conditional][conditional field="h8" condition="(h8).is('')"][select memo="Skin
" name="skin" value="|**Skin:** Normal
|**Skin:** Abnormal"][/conditional][conditional field="skin" condition="(skin).is('**Skin:** Abnormal')"]: [text name="abn_skin" default=""]
[/conditional][checkbox memo="Udder Left Front" memo_size="large" name="h9" value=""]
[conditional field="h9" condition="(h9).is('')"]**UDDER**
**Left Front**
[/conditional][conditional field="h9" condition="(h9).is('')"][select memo="Palpation
" name="palp_lf" value="|**Palpation:** Normal
|**Palpation:** Abnormal"][/conditional][conditional field="palp_lf" condition="(palp_lf).is('**Palpation:** Abnormal')"]: [text name="abn_palp_lf" default=""]
[/conditional][conditional field="h9" condition="(h9).is('')"][select memo="Teats
" name="teats_lf" value="|**Teats:** Normal
|**Teats:** Abnormal"][/conditional][conditional field="teats_lf" condition="(teats_lf).is('**Teats:** Abnormal')"]: [text name="abn_teats_lf" default=""]
[/conditional][conditional field="h9" condition="(h9).is('')"][select memo="Strip Cup
" name="sc_lf" value="|**Strip Cup:** Normal
|**Strip Cup:** Abnormal"][/conditional][conditional field="sc_lf" condition="(sc_lf).is('**Strip Cup:** Abnormal')"]: [text name="abn_sc_lf" default=""]
[/conditional][conditional field="h9" condition="(h9).is('')"][select memo="CMT
" name="cmt_lf" value="|**CMT:** Normal
|**CMT:** Abnormal"][/conditional][conditional field="cmt_lf" condition="(cmt_lf).is('**CMT:** Abnormal')"]: [text name="abn_cmt_lf" default=""]
[/conditional][checkbox memo="Udder Left Rear" memo_size="large" name="h11" value=""]
[conditional field="h11" condition="(h11).is('')"]**UDDER**
**Left Rear**
[/conditional][conditional field="h11" condition="(h11).is('')"][select memo="Palpation
" name="palp_lr" value="|**Palpation:** Normal
|**Palpation:** Abnormal"][/conditional][conditional field="palp_lr" condition="(palp_lr).is('**Palpation:** Abnormal')"]: [text name="abn_palp_lr" default=""]
[/conditional][conditional field="h11" condition="(h11).is('')"][select memo="Teats
" name="teats_lr" value="|**Teats:** Normal
|**Teats:** Abnormal"][/conditional][conditional field="teats_lr" condition="(teats_lr).is('**Teats:** Abnormal')"]: [text name="abn_teats_lr" default=""]
[/conditional][conditional field="h11" condition="(h11).is('')"][select memo="Strip Cup
" name="sc_lr" value="|**Strip Cup:** Normal
|**Strip Cup:** Abnormal"][/conditional][conditional field="sc_lr" condition="(sc_lr).is('**Strip Cup:** Abnormal')"]: [text name="abn_sc_lr" default=""]
[/conditional][conditional field="h11" condition="(h11).is('')"][select memo="CMT
" name="cmt_lr" value="|**CMT:** Normal
|**CMT:** Abnormal"][/conditional][conditional field="cmt_lr" condition="(cmt_lr).is('**CMT:** Abnormal')"]: [text name="abn_cmt_lr" default=""]
[/conditional][checkbox memo="Udder Right Front" memo_size="large" name="h10" value=""]
[conditional field="h10" condition="(h10).is('')"]**UDDER**
**Right Front**
[/conditional][conditional field="h10" condition="(h10).is('')"][select memo="Palpation
" name="palp_rf" value="|**Palpation:** Normal
|**Palpation:** Abnormal"][/conditional][conditional field="palp_rf" condition="(palp_rf).is('**Palpation:** Abnormal')"]: [text name="abn_palp_rf" default=""]
[/conditional][conditional field="h10" condition="(h10).is('')"][select memo="Teats
" name="teats_rf" value="|**Teats:** Normal
|**Teats:** Abnormal"][/conditional][conditional field="teats_rf" condition="(teats_rf).is('**Teats:** Abnormal')"]: [text name="abn_teats_rf" default=""]
[/conditional][conditional field="h10" condition="(h10).is('')"][select memo="Strip Cup
" name="sc_rf" value="|**Strip Cup:** Normal
|**Strip Cup:** Abnormal"][/conditional][conditional field="sc_rf" condition="(sc_rf).is('**Strip Cup:** Abnormal')"]: [text name="abn_sc_rf" default=""]
[/conditional][conditional field="h10" condition="(h10).is('')"][select memo="CMT
" name="cmt_rf" value="|**CMT:** Normal
|**CMT:** Abnormal"][/conditional][conditional field="cmt_rf" condition="(cmt_rf).is('**CMT:** Abnormal')"]: [text name="abn_cmt_rf" default=""]
[/conditional][checkbox memo="Udder Right Rear" memo_size="large" name="h12" value=""]
[conditional field="h12" condition="(h12).is('')"]**UDDER**
**Right Rear**
[/conditional][conditional field="h12" condition="(h12).is('')"][select memo="Palpation
" name="palp_rr" value="|**Palpation:** Normal
|**Palpation:** Abnormal"][/conditional][conditional field="palp_rr" condition="(palp_rr).is('**Palpation:** Abnormal')"]: [text name="abn_palp_rr" default=""]
[/conditional][conditional field="h12" condition="(h12).is('')"][select memo="Teats
" name="teats_rr" value="|**Teats:** Normal
|**Teats:** Abnormal"][/conditional][conditional field="teats_rr" condition="(teats_rr).is('**Teats:** Abnormal')"]: [text name="abn_teats_rr" default=""]
[/conditional][conditional field="h12" condition="(h12).is('')"][select memo="Strip Cup
" name="sc_rr" value="|**Strip Cup:** Normal
|**Strip Cup:** Abnormal"][/conditional][conditional field="sc_rr" condition="(sc_rr).is('**Strip Cup:** Abnormal')"]: [text name="abn_sc_rr" default=""]
[/conditional][conditional field="h12" condition="(h12).is('')"][select memo="CMT
" name="cmt_rr" value="|**CMT:** Normal
|**CMT:** Abnormal"][/conditional][conditional field="cmt_rr" condition="(cmt_rr).is('**CMT:** Abnormal')"]: [text name="abn_cmt_rr" default=""]
[/conditional][checkbox memo="Rectal" memo_size="large" name="h13" value=""]
[conditional field="h13" condition="(h13).is('')"]**RECTAL**
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Peritoneum
" name="perit" value="|**Peritoneum:** Normal
|**Peritoneum:** Abnormal"][/conditional][conditional field="perit" condition="(perit).is('**Peritoneum:** Abnormal')"]: [text name="abn_perit" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Rumen
" name="rectal_rumen" value="|**Rumen:** Normal
|**Rumen:** Abnormal"][/conditional][conditional field="rectal_rumen" condition="(rectal_rumen).is('**Rumen:** Abnormal')"]: [text name="abn_rectal_rumen" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Right Abdomen
" name="rectal_rt_abd" value="|**Right Abdomen:** Normal
|**Right Abdomen:** Abnormal"][/conditional][conditional field="rectal_rt_abd" condition="(rectal_rt_abd).is('**Right Abdomen:** Abnormal')"]: [text name="abn_rectal_rt_abd" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Left Kidney
" name="kidney" value="|**Left Kidney:** Normal
|**Left Kidney:** Abnormal"][/conditional][conditional field="kidney" condition="(kidney).is('**Left Kidney:** Abnormal')"]: [text name="abn_kidney" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Bladder/Ureters
" name="blad" value="|**Bladder/Ureters:** Normal
|**Bladder/Ureters:** Abnormal"][/conditional][conditional field="blad" condition="(blad).is('**Bladder/Ureters:** Abnormal')"]: [text name="abn_blad" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Lymph Nodes
" name="ln" value="|**Lymph Nodes:** Normal
|**Lymph Nodes:** Abnormal"][/conditional][conditional field="ln" condition="(ln).is('**Lymph Nodes:** Abnormal')"]: [text name="abn_ln" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Cervix
" name="cx" value="|**Cervix:** Normal|**Cervix:** Abnormal"][/conditional][conditional field="cx" condition="(cx).is('**Cervix:** Abnormal')"]: [text name="abn_cx" default=""]
[/conditional][conditional field="cx" condition="(cx).is('**Cervix:** Normal')"]: [text name="score_cx" default="score"]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Uterus
" name="ut" value="|**Uterus:** Normal|**Uterus:** Abnormal"][/conditional][conditional field="ut" condition="(ut).is('**Uterus:** Abnormal')"]: [text name="abn_ut" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Ovaries
" name="ov" value="|**Ovaries:** Normal
|**Ovaries:** Abnormal"][/conditional][conditional field="ov" condition="(ov).is('**Ovaries:** Abnormal')"]: [text name="abn_ov" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Vesicular GI
" name="vesc" value="|**Vesicular GI:** Normal
|**Vesicular GI:** Abnormal"][/conditional][conditional field="vesc" condition="(vesc).is('**Vesicular GI:** Abnormal')"]: [text name="abn_vesc" default=""]
[/conditional][conditional field="h13" condition="(h13).is('')"][select memo="Inguinal Rings
" name="ing" value="|**Inguinal Rings:** Normal
|**Inguinal Rings:** Abnormal"][/conditional][conditional field="ing" condition="(ing).is('**Inguinal Rings:** Abnormal')"]: [text name="abn_ing" default=""]
[/conditional][checkbox memo="Ancillary Findings" memo_size="large" name="ancbox" value=""][conditional field="ancbox" condition="(ancbox).is('')"]
**ANCILLARY FINDINGS**[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][comment memo="Header
"][checkbox name="pcv" value="
**PCV/TP:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="pcvtext" memo="text
"][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="rumenph" value="
**Rumen pH:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="rumenphtext" memo="text
"]
[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="urinesg" value="**Urine SG:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="urinesgtext" memo="text"]
[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="dipstick" value="**Dipstick:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="dipsticktext" memo="text"]
[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="fecalob" value="**Fecal Occult Blood:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="fecalobtext" memo="text"]
[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="fecalfloat" value="**Fecal Float:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="fecalfloattext" memo="text"]
[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="abdominocentesis" value="**Abdominocentesis:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="abdominocentesistext" memo="text"]
[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="cellularity" value="**Cellularity:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="cellularitytext" memo="text"]
[/conditional][conditional field="ancbox" condition="(ancbox).is('')"][checkbox name="differential" value="**Differential:** "][/conditional][conditional field="ancbox" condition="(ancbox).is('')"][text name="differentialtext" memo="text"][/conditional]
[checkbox name="other_findings" value="**OTHER FINDINGS**"]
[conditional field="other_findings" condition="(other_findings).is('**OTHER FINDINGS**')"] [textarea name="other_findings_text" default=""][/conditional]
**PROBLEM LIST**
[textarea name="prob_text" default=""]
**DIFFERENTIAL DIAGNOSIS:**
[textarea name="dx_text" default=""]
**GENERAL**
**Body Weight:** lbs
**Temperature:** *F
**Pulse / HR:** / min
**Resp. Rate:** / min
**Ruminations:** / 2 min
**Body Condition:** /9
**Mental Status:**
**Posture:**
**Gait / Strength:**

Head and Neck
Thorax
Limbs-Left-Front
Limbs-Left-Hind
Limbs-Right-Front
Limbs-Right-Hind
Abdomen-Left
Abdomen-Right
Perineum
Integument
Udder Left Front
Udder Left Rear
Udder Right Front
Udder Right Rear
Rectal
Ancillary Findings


**PROBLEM LIST**

**DIFFERENTIAL DIAGNOSIS:**

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.51, 406 form elements, 25 boilerplate words, 100 text boxes, 3 text areas, 27 checkboxes, 80 drop downs, 1 comments, 195 conditionals, 210 total clicks
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