MA TEMPLATES

[checkbox value="Covid-19 AG-"][select name="variable_1" value="Result|Positive|Negative"]

[checkbox value="Rapid Strep-"][select name="variable_1" value="Result|Positive|Negative"]

[checkbox value="Mono Spot-"][select name="variable_1" value="Result|Positive|Negative"]

[checkbox value="Influenza-"][select name="variable_1" value="Result|Negative|A Positive|B Positive|AB Positive"]

[checkbox value="Pregnancy Test-"][select name="variable_1" value="Result|Positive|Negative"]

[checkbox value="UA"]
LEU:[text size="3"]
NIT:[text size="3"]
URO:[text size="3"]
PRO:[text size="3"]
pH: [text size="3"]
BLO:[text size="3"]
SG: [text size="3"]
KET:[text size="3"]
BIL:[text size="3"]
GLU:[text size="3"]


[checkbox value="Glucose:"][text size="3"]

[checkbox value="EKG"]

[checkbox value="XRAY"]