{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"W ALIAGSBBOC ","gend":1,"add":"SSOR 043TEERTS ","city":"DANVILLE","state":"VA","zip":245411727,"dob":"1955-07-23","age":"","mstatus":"","insh":"10116902","cliId":"2GG9KR0FC55","pno":"0743407929","cno":"","email":"","ename":"","eno":"","pphy":"TRIVEDI, RAJENDRA S","ppno":4347923730,"pcpadd":"340 ROSS STREET","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":245411727,"pcpcounty":"Danville City","pcpid":"P0060294","pcpname":"MEMORIAL FAMILY CARE INC","pcpfaxno":""},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["R19.7","J10.2","R11.0","R10.30","L02.412","E11.42","I10","R22.32"],"date":["2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-05-22","2020-05-22","2020-05-29","2020-05-29"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["Yes","Select","",false,""],["Yes","Select","",false,""],["No","Select","",false,""],["Yes","Select","",false,""],["No","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""]]]},{"t":"Self-assessment & 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":{"indx":[{"index":7,"values":[{"index":"No Ethnicity"}]}],"comment":[],"score":0}}]},{"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","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":[null,null,null,null,null,null,""]},{"a":[0,"","",0,{"txt":""},{"malnutrition":[]}]}]},{"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","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"icd-10","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a9":"","a10":[],"a11":""}]}]}