Palliative care-Nausea

[text name="variable_1" default="sample text"]
[textarea name="variable_1" default="sample text"]

[date name="variable_1" default="07/16/2020"]
[radio name="variable_1" value="choice A|choice B|choice C"]
[checkbox name="variable_1" value="option A|option B|option C"]





Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.6, 5 form elements, 1 text boxes, 1 text areas, 1 dates, 1 checkboxes, 1 radio buttons, 7 total clicks
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