SIGNATURE (28)    DATA FIELD (357.5)

Name Value
NAME SIGNATURE
BLOCK PROGRESS NOTES (V2.1)
TYPE OF DATA IBDF UTILITY FOR LABELS ONLY
SUBFIELD
  • SUBFIELD LABEL:   Provider Signature:
    STARTING COLUMN FOR LABEL:   30
    STARTING ROW FOR LABEL:   9
    STARTING ROW FOR DATA:   10
    STARTING COLUMN FOR DATA:   50
    LENGTH OF DATA:   50
    DATA:   1