Female Review of Systems

[textarea default="Ears: no trouble hearing/dizziness/balance problems."]
[textarea default="Eyes: no blurring/double vision/spots."]
[textarea default="Throat: no pain/trouble swallowing."]
[textarea default="Neck: no painful nodes."]
[textarea default="Thyroid: no tremor/palpitations/anxiety/heat or cold intolerance/unusual fatigue."]
[textarea default="Chest: no cough/sputum/SOB/chest pain."]
[textarea default="CVS: no CP/heaviness/jaw or arm pain/palpitations/leg pain with exercise/edema."]
[textarea default="GI: no constipation/diarrhea/blood in stool/melena."]
[textarea default="GU: no dysuria/frequency/blood in urine/incontinence."]
[textarea default="Gyne: no vaginal pain/discharge/trouble with intercourse."]
[textarea default="MS: no pain/swelling in muscles or joints."]
[textarea default="Neuro: no HA."]

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 12 form elements, 12 text areas, 12 total clicks
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