Chief complaint

The patient is a 
[text name="variable_1" default="age"] [select name="variable_1" value="Male|Female|"] who presents to the today complaining of [text name="variable_1" default="CHIEF COMPLAINT"]that began [text name="variable_1" default="ONSET"] while [text name="variable_1" default="CONTEXT"], Symptoms have been [select name="variable_1" value="intermittent|constant|"] since onset and he/she rates them as [select name="variable_1" value="mild|moderate|severe"] in severity. Patient reports the symptoms are located [text name="variable_1" default="LOCATION"]and describes the quality as [select name="variable_1" value="dull|sharp|ache|tightness|pressure"]. Per patient, he/she has had associated [text name="variable_1" default="POSITIVE SYMPTOMS"]but denies any [text name="variable_1" default="NEGATIVE SYMPTOMS"]. Symptoms are improved with [text name="variable_1" default="MODIFYING FACTOR"] and exacerbated by [text name="variable_1" default="MODIFYING FACTOR"]. Patient [select name="variable_1" value="REPORTS|DENIES|"]history of similar symptoms. Pertinent medical history includes [text name="variable_1" default="PERTINENT PAST MEDICAL HISTORY"]. Patient adds [text name="variable_1" default="sample text"]
The patient is a
who presents to the today complaining of that began while , Symptoms have been since onset and he/she rates them as in severity. Patient reports the symptoms are located and describes the quality as . Per patient, he/she has had associated but denies any . Symptoms are improved with and exacerbated by . Patient history of similar symptoms. Pertinent medical history includes . Patient adds

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Sandbox Metrics: Structured Data Index 0.31, 16 form elements, 66 boilerplate words, 11 text boxes, 5 drop downs, 16 total clicks
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