[select name="caller_1" value="Mother|Father|Grandmother"] reports patient has been [textarea name="variable_1" default=""] for the past [text name="variable_1" default=""] [select name="variable_1" value="hours|days|weeks"].
reports patient has been
for the past .

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.5, 4 form elements, 7 boilerplate words, 1 text boxes, 1 text areas, 2 drop downs, 4 total clicks
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