[text name="variable_1" default="Name"] is a [text name="variable_1" default="Age"] year-old [checkbox name="variable_1" value="male|female"] with a PMHx of [text name="variable_1" default="History"] that is post-op day [text name="variable_1" default="Number of days"] following [text name="variable_1" default="Procedure"].

Patient reports "[text name="variable_1" default="Subjective"]". Overnight, the patient had [text name="variable_1" default="Adverse event?"]. Pain overnight rated as [select name="variable_1" value="1|2|3|4|5|6|7|8|9|10"]/10 controlled with [text name="variable_1" default="Drug(s)"]. 

Patient reports [select name="variable_1" value="flatus|no flatus"] and [select name="variable_1" value="no bowel movements|1 bowel movement|2 bowel movements|3 bowel movements|4 bowel movements|> 5 bowel movements"] and has [select name="variable_1" value="not ambulated|ambulated once|ambulated twice|ambulated 3 times|ambulated 4 times|ambulated 5 times|ambulated > 5 times"] in the past 24 hours. 

BP: [radio name="variable_1" value="WNL|Tranding upward|Trending downward"]
is a year-old with a PMHx of that is post-op day following .

Patient reports "". Overnight, the patient had . Pain overnight rated as /10 controlled with .

Patient reports and and has in the past 24 hours.


Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.43, 14 form elements, 35 boilerplate words, 8 text boxes, 1 checkboxes, 1 radio buttons, 4 drop downs, 15 total clicks
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