Peds HPI

This is a[text name="variable_1" default=""] year old [select name="gender" value="female|male"] admitted to psychiatry [text name="variable_1" default=""]. Hospital Peds consulted day [text name="variable_1" default=""]for CC of [text name="variable_1" default=""]. Previously, patient [textarea name="field_name" default="sample text"]. The area of concern [textarea name="field_name" default="sample text"]. Duration last [textarea name="field_name" default="sample text"]. The problems are described [textarea name="field_name" default="sample text"]. [textarea name="field_name" default="sample text"] makes it worse. [textarea name="field_name" default="sample text"] makes it better. The problem was first notice in [textarea name="field_name" default="sample text"]. Remedies tried [textarea name="field_name" default="sample text"] with [textarea name="field_name" default="sample text"] help. Patient has [textarea name="field_name" default="sample text"] allergies. Associatied symptoms include [textarea name="field_name" default="sample text"], but denies [textarea name="field_name" default="sample text"]. Patient's symptoms has affected [textarea name="field_name" default="sample text"]. On 0-5 level of distress is [textarea name="field_name" default="sample text"] 

Past family history: [textarea name="field_name" default="sample text"].

Past Surgical History: [textarea name="field_name" default="sample text"].

Social History: [textarea name="field_name" default="sample text"]
This is a year old admitted to psychiatry . Hospital Peds consulted day for CC of . Previously, patient . The area of concern . Duration last . The problems are described . makes it worse. makes it better. The problem was first notice in . Remedies tried with help. Patient has allergies. Associatied symptoms include , but denies . Patient's symptoms has affected . On 0-5 level of distress is

Past family history: .

Past Surgical History: .

Social History:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.05, 22 form elements, 69 boilerplate words, 4 text boxes, 17 text areas, 1 drop downs, 22 total clicks
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