URI Rod Comlete
[comment memo="HPI"] Patient presents for evaluation of [text name= default=""][comment memo="duration"][text name= default=""]. Patient reports associated symptoms of [checkbox name= value="sore throat|non-productive cough|productive cough|nasal congestion|rhinorrhea|subjective fever|fatigue|headache|abdominal pain|diarrhea|ear pain| facial pain| ansomia |Dysgeusia |Appetite normal| Appetite decreased| normal wet nappies| decreased wet nappies|Rash"] Patient denies [checkbox name= value="sore throat|non-productive cough|productive cough|nasal congestion|rhinorrhea|subjective fever|fatigue|headache|abdominal pain|diarrhea|ear pain| facial pain|CP|SOB|LE edema|syncopy|Hemoptasis| ansomia |Dysgeusia |dyspnea|Rash"]. Patient reports [select name= value="no sick contacts|sick contacts"] Treatment Patient has tried [checkbox value="nothing|acteminophen|ibuprofen|OTC cough medications|DayQuil"] for symptoms. [textarea name="variable_1" default=""] [checkbox value="+ tobacco use|No tobacco use|hx of asthma | No DVT risk factos|+ flu vaccine this season|No flu vaccine this season|Recent international travel|Immunizations Up-to-date"]
Result - Copy and paste this output:
Sandbox Metrics: Structured Data Index 0.63, 10 form elements, 20 boilerplate words, 2 text boxes, 1 text areas, 4 checkboxes, 1 drop downs, 2 comments, 57 total clicks
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