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
