| Provider: | {{Document.treatment.providers[0].providerName}} | Patient: | {{Document.targetPatient.name}} |
|---|---|---|---|
| Treatment: | {{Document.treatment.service}} | Date of birth: | {{Document.targetPatient.dob}} |
| Treatment Start Date: | {{Document.treatment.serviceStartDate}} | Gender: | {{Document.targetPatient.gender}} |
| Treatment End Date: | {{Document.treatment.serviceEndDate}} | Patient Id: | {{Document.targetPatient.ids[0].slice(0,Document.targetPatient.ids[0].indexOf("^"))}} |
{{paragraph.text}}
{{paragraph.renderMultiMedia.caption.text}}
{{content.text}}
| {{th.text}} | {{td.text}} |
|---|---|
| {{th.text}} | {{td.text}} |
| {{th.text}} | {{td.text}} |
|---|---|
| {{th.text}} | {{td.text}} |