Bronchitis History
History provided by [text] The patient has had symptoms for [text] days Pertinent positives include: [checkbox value="cough|chest congestion|shortness of breath|wheezing|productive cough|non-productive cough"] Sputum is [select value="clear|purulent|blood-tinged"] Other recent symptoms include: [checkbox value="sore throat|nasal congestion|earache|headache|myalgias|fever"] Pertinent negatives include: [checkbox value="sore throat|nasal congestion|earache|headache|myalgias|fever"] Past History: [select value="no|yes"] chronic respiratory problems [select value="no|yes"] frequent pneumonia [select value="no|yes"] frequent bronchitis [select value="no|yes"] asthma [select value="current|former|exposure to second hand"] tobacco use [select value="no|yes"] occupational exposure to potentially harmful inhalants
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Sandbox Metrics: Structured Data Index 0.83, 12 form elements, 40 boilerplate words, 2 text boxes, 3 checkboxes, 7 drop downs, 27 total clicks
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