NATIONAL ADHC FY16-Q3 (605)    ENCOUNTER FORM (357)

Name Value
NAME NATIONAL ADHC FY16-Q3
SIMPLEX/DUPLEX DUPLEX,SHORT-EDGE BINDING
BRIEF DESCRIPTION National Adult Day Health Care May 2016
TYPE OF USE OUTPATIENT ENCOUNTER FORM
COMPILED? NO
USE ICR? YES
TOOLKIT YES
RIGHT MARGIN 133
PAGE LENGTH 80
NUMBER OF PAGES 3
SCANNED/MANUAL DATA ENTRY YES
PAPER SIZE LETTER (8 1/2 x 11)
ORIENTATION PORTRAIT
TEXT SIZE 133 COLUMNS x 80 LINES
VERSION 3