Top | Left | Top | Left | |||
Patients Name | 36 | 35 | Drs Name | 243 | 35 | |
Patients Address | 41 | 35 | Dr’s Addr | 248 | 35 | |
Patients DOB | 50 | 35 | Dr’s Prov# | 248 | 150 | |
Sex | 50 | 143 | Copies to | 272 | 35 | |
Medicare# | 50 | 100 | Request Date | 262 | 35 | |
DVA # | 50 | 100 | Request ID | 0 | 0 | |
Phone # | 36 | 141 | Patient Mobile # | 44 | 141 |
Top | Left | Width | Lines | |
Requested test | 65 | 20 | 125 | 10 |
Clinical Details | 135 | 20 | 125 | 10 |
Left | Top | Left | Top | |||
Patients Name | 35 | 36 | Drs Name | 35 | 243 | |
Patients Address | 35 | 41 | Dr’s Addr | 35 | 248 | |
Patients DOB | 35 | 50 | Dr’s Prov# | 150 | 248 | |
Sex | 143 | 50 | Copies to | 35 | 272 | |
Medicare# | 100 | 50 | Request Date | 35 | 262 | |
DVA # | 100 | 50 | Request ID | 0 | 0 | |
Phone # | 141 | 36 | Patient Mobile # | 141 | 44 |
Left | Top | Width | Lines | |
Requested test | 20 | 65 | 125 | 10 |
Clinical Details | 20 | 135 | 125 | 10 |