{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THOMAS R RAMSEY","gend":0,"add":"479 FLAT TOP RD","city":"BLAND","state":"VA","zip":243159999,"dob":"1956-05-31","age":"","mstatus":"","insh":11012358,"cliId":"7TH8FE2KK33","pno":2766133141,"cno":2762285595,"email":"","ename":"","eno":"","pphy":"GRIFFIN, SUSAN R","ppno":2762286499,"pcpadd":"1785 W Lee Hwy","pcpcity":"Wytheville","pcpstate":"VA","pcpzip":243821437,"pcpcounty":"BLAND","pcpid":"P0060318","pcpname":"FOREST FAMILY CARE"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["E78.5","E03.9","D64.9","E83.42","J44.9","Z12.5","S60.552A","S61.442A","W45.8XXA","G40.909","E78.00","Z79.899","S63.112A","M79.645","S60.352D","S69.92XA","M79.89","S60.352A","M79.5","Z88.5","Z88.0","Z87.891","Z86.718","Z86.73","Z88.1","Z87.442","R56.9","S61.002A","Z48.89"],"date":["2020-07-21","2020-07-21","2020-06-29","2020-06-29","2020-07-21","2020-06-29","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2020-07-21","2020-07-14","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-08-03"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["No","Select","",false,""],["No","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":""}]}]}