{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELLA V FISHER","gend":1,"add":"8641 STATE ROAD 70","city":"BLACKWATER","state":"VA","zip":242219999,"dob":"1943-12-18","age":"","mstatus":"","insh":11015845,"cliId":"7DF8KM2JP34","pno":2763461594,"cno":"","email":"","ename":"","eno":"","pphy":"VANZEE, WAYNE A","ppno":2763834228,"pcpadd":"100 MAIN STREET","pcpcity":"SAINT CHARLES","pcpstate":"VA","pcpzip":242820001,"pcpcounty":"","pcpid":"P0060054","pcpname":"ST CHARLES COMMUNITY HEALTH CLINIC"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J44.9","D51.0","Z00.8","D64.9","E55.9","M81.8","J96.12","Z51.81","Z23","Z71.89","Z13.89","Z13.9","Z79.891"],"date":["2020-10-26","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["Yes","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":""}]}]}