MOIMSD General Visit

[checkbox memo="Follow    up"  memo_style="bold-italic" memo_size="small" name="VAC111111" value="Follow    up    visit:"][conditional field="VAC111111" condition="(VAC111111).is('Follow    up    visit:')"] 
-Patient responce to treatment was [select value="adequet.|suboptimal.|without    any improvment."]    
-Patien [select value="adhere|did not adhere|"] to the treatment plan.
-Patient did not experiance any complications or side effects to the treatment.
-Plan reassement: [select name="variable_8" value="Complete same plan.|Change the to the following:"][conditional field="variable_8" condition="(variable_8).is('Change    the    to    the    following:')"] [textarea    default=":"][/conditional] [/conditional]

[comment memo_color="black" memo="Paste    this    in    the    visit    info    section,    the    left    side    (illness)"]
Chief Complaints: 
[textarea cols=80 rows=1]
History of Present Illness: 
[textarea cols=80 rows=5]

[link url="" memo="«Press Here    to    Proceed»"]

Follow up

Paste this in the visit info section, the left side (illness)
Chief Complaints:

History of Present Illness:

«Press Here to Proceed»

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.57, 11 form elements, 7 boilerplate words, 3 text areas, 1 checkboxes, 3 drop downs, 1 links, 1 comments, 2 conditionals, 7 total clicks
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