MS
[select value="RUE|LUE|RLE|LLE"] [checkbox value="full movement|limited movement|swelling|deformity|paralysis|amputation|ace wrap|brace|contracture|immobilizer|injury/trauma|no deformity|no devices/equipment|prosthesis|sling|splint"]
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Sandbox Metrics: Structured Data Index 1, 2 form elements, 1 checkboxes, 1 drop downs, 17 total clicks
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