Name	Value
REPORT NUMBER	36
INSTRUMENT	CPR 1
RPT	\|Test only\|\|Date Given: <.Date_Given.>\|Clinician: <.Staff_Ordered_By.>\|Location: <.Location.>\|\|Veteran: <.Patient_Name_Last_First.>\|SSN: <.Patient_SSN.>\|DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)\|Gender: <.Patient_Gender.>\| <_Script_3_> <_Script_4_> $~

Name

Value

REPORT NUMBER

INSTRUMENT

RPT

|Test only||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB: <.Patient_Date_Of_Birth.> 
(<.Patient_Age.>)|Gender: <.Patient_Gender.>| <_Script_3_>  <_Script_4_>  $~

36 (36) MH REPORT (601.93)