| Name | Value |
|---|---|
| NAME | PATIENT INFORMATION (V2.1) |
| FORM | PRIMARY CARE SAMPLE V2.1 |
| BLOCK'S STARTING ROW | 1 |
| BLOCK'S STARTING COLUMN | 0 |
| WIDTH IN CHARACTERS | 63 |
| HEIGHT IN LINES | 21 |
| OUTLINE TYPE | SOLID LINE |
| BLOCK HEADER | PATIENT INFORMATION |
| HEADER APPEARANCE | CR |
| BRIEF DESCRIPTION | Name,sex,DOB,PID,eligibilty,address,telephone |
| TOOLKIT ORDER | 0 |