BOP- Chronic Care Clinic

[text name="variable_1" default="AGE"] yr old AIC presents to HS today for f/up on CCC:

1. [text name="variable_2" default=""]
[textarea name="variable_6" default=""]

2. [text name="variable_3" default=""]
[textarea name="variable_7" default=""]

3. [text name="variable_4" default=""]
[textarea name="variable_8" default=""]

4. [text name="variable_5" default=""]
[textarea name="variable_9" default=""]

5. [text name="variable_10" default=""]
[textarea name="variable_11" default=""]

6.[text name="variable_12" default=""]
[textarea name="variable_13" default=""]


--------------------------------------------
PLAN:
1. [text name="variable_2" default=""]
[textarea name="variable_14" default=""]

2. [text name="variable_3" default=""]
[textarea name="variable_15" default=""]

3. [text name="variable_4" default=""]
[textarea name="variable_16" default=""]

4. [text name="variable_5" default=""]
[textarea name="variable_17" default=""]

5. [text name="variable_10" default=""]
[textarea name="variable_18" default=""]

6.[text name="variable_12" default=""]
[textarea name="variable_19" default=""]

yr old AIC presents to HS today for f/up on CCC:

1.


2.


3.


4.


5.


6.



--------------------------------------------
PLAN:
1.


2.


3.


4.


5.


6.


Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 25 form elements, 14 boilerplate words, 13 text boxes, 12 text areas, 25 total clicks
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