Pharyngitis History
[checkbox memo="Version A" name="A" value=""][conditional field="A" condition="(A).is('')"]Duration of symptoms in days [text] Pertinent positives [select value="no|YES"] <-- fever [select value="no|YES"] <-- malaise [select value="no|YES"] <-- swollen lymph nodes [select value="no|YES"] <-- cough [select value="no|YES"] <-- headache [select value="no|YES"] <-- rash [select value="good|adequate|poor"] <-- Intake pattern [select value="good|adequate|poor|constipation"] <-- Elimination pattern [textarea cols=80 rows=5 default=""][/conditional][checkbox memo="Version B" name="B" value=""][conditional field="B" condition="(B).is('')"][textarea cols=80 rows=5 default="Patient has had *** days of ***sore throat/dysphonia/fever/cough/difficulty swallowing/nasal congestion/headache***. Patient has had no ***dysphonia/fever/cough/difficulty swallowing/nasal congestion/headache***. There ***are no known/have been*** recent exposures to Strep. The patient ***has not had/has had*** Strep pharyngitis in the past 30 days. Other history/symptoms: ***nausea/vomiting/mild abdominal ache/diarrhea/rash/refusing to eat/refusing to drink/body aches/eye irritation/ear pain/facial pain/shortness of breath/arthralgias/myalgias/exposure to Mono***."][/conditional]
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Sandbox Metrics: Structured Data Index 0.67, 4 form elements, 164 boilerplate words, 1 text boxes, 1 checkboxes, 1 drop downs, 1 conditionals, 3 total clicks
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