NATIONAL BLIND REHAB FY13-Q2 (20)    ENCOUNTER FORM (357)

Name Value
NAME NATIONAL BLIND REHAB FY13-Q2
SIMPLEX/DUPLEX SIMPLEX
BRIEF DESCRIPTION National Blind Rehab Service Encounter form-Updated January 2013
TYPE OF USE OUTPATIENT ENCOUNTER FORM
COMPILED? NO
USE ICR? NO
TOOLKIT YES
RIGHT MARGIN 133
PAGE LENGTH 80
NUMBER OF PAGES 1
SCANNED/MANUAL DATA ENTRY YES
PAPER SIZE LETTER (8 1/2 x 11)
ORIENTATION PORTRAIT
TEXT SIZE 133 COLUMNS x 80 LINES
PAGE INFORMATION
  • 1
    SCANNABLE?:   YES, PAGE SCANNABLE