Top | Left | Top | Left | |||
Patients Name | 38 | 35 | Drs Name | 242 | 35 | |
Patients Address | 47 | 35 | Dr’s Addr | 252 | 35 | |
Patients DOB | 65 | 35 | Dr’s Prov# | 242 | 154 | |
Sex | N/A | N/A | Copies to | 278 | 35 | |
Medicare# | 65 | 132 | Request Date | 269 | 135 | |
DVA # | 65 | 132 | Request ID | 0 | 0 | |
Phone # | 56 | 35 | Patient Mobile # | 56 | 132 | |
Dr’s Phone | 260 | 35 | ||||
Dr’s Fax | 260 | 135 |
Top | Left | Width | Lines | |
Requested test | 84 | 20 | 125 | 10 |
Clinical Details | 150 | 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 |