{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NOVELLA B COLLILNS","gend":1,"add":"11194 SEALEY RD","city":"BIRDSNEST","state":"VA","zip":233079999,"dob":"1930-03-19","age":"","mstatus":"","insh":11010878,"cliId":"8VF0RK7XQ45","pno":7576932517,"cno":"","email":"","ename":"","eno":"","pphy":"CHICK, JON BLAIR","ppno":7573363682,"pcpadd":"4049 Main St","pcpcity":"Chincoteague Island","pcpstate":"VA","pcpzip":233362406,"pcpcounty":"NORTHAMPTON","pcpid":"P9476151","pcpname":"EASTERN SHORE RURAL HEALTH SYSTEM"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["I10","R15.9","R39.81","F03.91","K59.09","M20.41","R35.0","M54.5","R82.998","R10.9","R44.3","R68.89","R51","E78.00","I12.9","N18.3","M10.9","Z87.891","R35.1","I73.9","M79.89","Z23","S00.11XA","G82.20"],"date":["2020-10-30","2020-11-01","2020-11-01","2020-08-27","2020-02-27","2020-07-06","2020-09-03","2020-04-03","2020-04-03","2020-08-03","2020-08-27","2020-10-01","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-26","2020-07-06","2020-10-02","2020-10-02","2020-10-02","2020-11-01"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","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 & 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","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":""}]}]}