ROS: Hematologic

HEMATOLOGIC/LYMPHATIC: [checkbox name="variable_155" value="Deferred"]
Excessive bleeding? [checkbox name="variable_156" value="Yes|No"]
     If yes, where? 
[checkbox name="variable_157" value="Skin|Gums|Joints"]
Lymphadenopathy? [checkbox name="variable_158" value="Yes|No"]
     If yes, where? 
[checkbox name="variable_159" value="Cervical|Supraclavicular|Infraclavicular|Preauricular|Submandibular|Delphian|Periumbilical|Epitrochlear|Inguinal|Anterior|Posterior|Right|Left"]
HEMATOLOGIC/LYMPHATIC:
Excessive bleeding?
If yes, where?

Lymphadenopathy?
If yes, where?

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 1, 5 form elements, 11 boilerplate words, 5 checkboxes, 21 total clicks
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