Transport

D: EMS was dispatched to [text name="variable_1" default="sample text"] for a [text name="variable_2" default="sample text"],[select name="variable_1" value="Med1|Med2|Med4"] went en-route [select name="variable_" value="emergent status|non-emergent status"] from [select name="variable_2" value="Station1|Station2"] driving with due regard for others and arriving on scene with zero incidents.

C: Patient chief complaint was [text name="variable_3" default="sample text"]

H: Patient has a history of [text name="variable_4" default="sample text"], allergies are [text name="variable_5" default="sample text"]

A: Patient was A&Ox[select name="variable_3" value="1|2|3|4"], with a GCS of [select name="variable_4" value="3|4|5|6|7|8|9|10|11|12|13|14|15"]. 
D: EMS was dispatched to for a , went en-route from driving with due regard for others and arriving on scene with zero incidents.

C: Patient chief complaint was

H: Patient has a history of , allergies are

A: Patient was A&Ox, with a GCS of .

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.5, 10 form elements, 45 boilerplate words, 5 text boxes, 5 drop downs, 10 total clicks
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