{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ELLEHCIMOLRACED L","gend":1,"add":"KRAP EDIT 361LIART      S","city":"PENNINGTON GAP","state":"VA","zip":242777040,"dob":"1977-07-22","age":"","mstatus":"","insh":"10110776","cliId":"1GV9AJ2UA45","pno":"4567291036","cno":2762020248,"email":"","ename":"","eno":"","pphy":"DEEL, SAMUEL P","ppno":2766799100,"pcpadd":"310 3rd St NE","pcpcity":"Norton","pcpstate":"VA","pcpzip":242731137,"pcpcounty":"","pcpid":"P9059241","pcpname":"WELLMONT MEDICAL ASSOCIATES INC","pcpfaxno":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":[],"date":[]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""]]]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":""}]}]}