NATIONAL BLIND REHAB FY15-Q4 (379)    ENCOUNTER FORM (357)

Name Value
NAME NATIONAL BLIND REHAB FY15-Q4
SIMPLEX/DUPLEX SIMPLEX
BRIEF DESCRIPTION National Blind Rehab Service Encounter form-Updated July 2015
TYPE OF USE OUTPATIENT ENCOUNTER FORM
COMPILED? NO
USE ICR? NO
TOOLKIT YES
RIGHT MARGIN 133
PAGE LENGTH 80
NUMBER OF PAGES 2
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