Typhon GYN

[text size="2"] YOF, G[text size="2"] P[text size="2"], here for [checkbox name="variable_1" value="OB visit|well-woman exam|Problem Visit"]
Patient Reports [select name="variable_1" value="no signs of preterm labor. |no changes to her PMH, and is in her usual state of health. | "][textarea]

-LMP [select name="variable_2" value="less than 30 Days ago|more than 30 days ago|None D/t IUD|None D/t Post Menopausal|None D/t Lactational Amenorrhea"]
-Birth Control Method: [text size="10"]
-Last Pap [text size="3"] years ago. Results: [select value="Cytology negative|ASCUS|LSIL|HSIL"] & [select value="-|+"] HPV; with [select value="-|+"]Hx of abnormal Pap [text size="40"]
-Last Mammogram [text size="3"] years ago. Results: [select value="BI-RADS 0|BI-RADS 1|BI-RADS 2|BI-RADS 3|BI-RADS 4|BI-RADS 5|BI-RADS 6"]; with [select value="-|+"]Hx of abnormal Mamogram[text size="40"]

[textarea name="variable_2" cols=80 rows=2 default="GENERAL: Well-developed, well-nourished, alert and cooperative, and appears to be in no acute distress."]
[textarea name="variable_8" cols=80 rows=1 default="NECK: Neck supple, non-tender without lymphadenopathy, masses or thyromegaly."]
[textarea name="variable_9" cols=80 rows=3 default="CARDIAC: Normal S1 and S2. No S3, S4 or murmurs. Rhythm is regular. There is no peripheral edema, cyanosis or pallor. Extremities are warm and well perfused. Capillary refill is less than 2 seconds. No carotid bruits."]
[textarea name="variable_10" cols=80 rows=2 default="LUNGS: Clear to auscultation and percussion without rales, rhonchi, wheezing or diminished breath sounds."]
[textarea name="variable_21" cols=80 rows=1 default="BREASTS: No masses, tenderness, asymmetry, nipple discharge or axillary lymphadenopathy."]
[textarea name="variable_22" cols=80 rows=3 default="PELVIC: Normally developed external female genitalia with no external lesions or eruptions. Vagina and cervix have no lesions, inflammation, discharge or tenderness. Cervix is nontender. Uterus is within normal limits with no adnexal fullness."]

1. [text size="40"]
2. [text size="40"]
3. Return to office in [checkbox name="variable_2" value="1 week|2 weeks|1 month|6 weeks|3 months|6 months|1 year|Within 5 days of the first day of the next period"]
YOF, G P, here for
Patient Reports

-Birth Control Method:
-Last Pap years ago. Results: & HPV; with Hx of abnormal Pap
-Last Mammogram years ago. Results: ; with Hx of abnormal Mamogram


3. Return to office in

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.35, 26 form elements, 39 boilerplate words, 10 text boxes, 7 text areas, 2 checkboxes, 7 drop downs, 35 total clicks
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