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Fiteen page letter with buttons HTML

HTML icon letter15pageButtonsGenericJan 2012.html — HTML, 85 kB (87590 bytes)

File contents

<html>
<head>
<title>Fifteen Page letter with buttons</title>

	<link rel="stylesheet" type="text/css" href="${oscar_image_path}JSMPC.css" />

<style type="text/css" media="print">
 .DoNotPrint {
	 display: none;
 }
 .noborder {
	 border : 0px;
	 background: transparent;
	 scrollbar-3dlight-color: transparent;
	 scrollbar-3dlight-color: transparent;
	 scrollbar-arrow-color: transparent;
	 scrollbar-base-color: transparent;
	 scrollbar-darkshadow-color: transparent;
	 scrollbar-face-color: transparent;
	 scrollbar-highlight-color: transparent;
	 scrollbar-shadow-color: transparent;
	 scrollbar-track-color: transparent;
	 background: transparent;
	 overflow: hidden;
 }
 </style>	
	
	<script language="javascript" type="text/javascript">
		/****************************
		startup functions 
		****************************/
		function startUp()
		{			
			// shows the forms on development machine from notepad ++ - saves you from uploading to the server to input alignments
			var strLoc = window.location.href.toLowerCase();
			if(strLoc.indexOf("https") == -1)
			{
				//page1
				var src = document.getElementById('BGImage').src;				
				document.getElementById('BGImage').src = src.replace('$%7Boscar_image_path%7D','');
				// page2
				var src2 = document.getElementById('BGImage2').src;
				document.getElementById('BGImage2').src = src2.replace('$%7Boscar_image_path%7D','');
				// page3
				var src3 = document.getElementById('BGImage3').src;
				document.getElementById('BGImage3').src = src3.replace('$%7Boscar_image_path%7D','');
				// page4
				var src4 = document.getElementById('BGImage4').src;
				document.getElementById('BGImage4').src = src4.replace('$%7Boscar_image_path%7D','');
				// page5
				var src5 = document.getElementById('BGImage5').src;
				document.getElementById('BGImage5').src = src5.replace('$%7Boscar_image_path%7D','');
				// page6
				var src6 = document.getElementById('BGImage6').src;
				document.getElementById('BGImage6').src = src6.replace('$%7Boscar_image_path%7D','');
				// page7
				var src7 = document.getElementById('BGImage7').src;
				document.getElementById('BGImage7').src = src7.replace('$%7Boscar_image_path%7D','');
				// page8
				var src8 = document.getElementById('BGImage8').src;
				document.getElementById('BGImage8').src = src8.replace('$%7Boscar_image_path%7D','');
				// page9
				var src9 = document.getElementById('BGImage9').src;
				document.getElementById('BGImage9').src = src9.replace('$%7Boscar_image_path%7D','');
				// page10
				var src10 = document.getElementById('BGImage10').src;
				document.getElementById('BGImage10').src = src10.replace('$%7Boscar_image_path%7D','');
				// page11
				var src11 = document.getElementById('BGImage11').src;
				document.getElementById('BGImage11').src = src11.replace('$%7Boscar_image_path%7D','');
				// page12
				var src12 = document.getElementById('BGImage12').src;
				document.getElementById('BGImage12').src = src12.replace('$%7Boscar_image_path%7D','');
				// page13
				var src13 = document.getElementById('BGImage13').src;
				document.getElementById('BGImage13').src = src13.replace('$%7Boscar_image_path%7D','');
				// page14
				var src14 = document.getElementById('BGImage14').src;
				document.getElementById('BGImage14').src = src14.replace('$%7Boscar_image_path%7D','');
				// page15
				var src15 = document.getElementById('BGImage15').src;
				document.getElementById('BGImage15').src = src15.replace('$%7Boscar_image_path%7D','');

			}
			setDocumentTitle('Fifteen Page letter with buttons',document.getElementById('patient_nameL').value);
			setDefaults();			
		}
		
		function setDocumentTitle(Title,PatientName)
		{
			// set document title
			document.title = Title + ' - ' + PatientName;					
							
		}
		
		function setDefaults()
		{	            
			// check the newform flag to ensure this is the initial load of the form
			if (document.getElementById("newForm").value == 'True')
			{
				document.getElementById("Female").value = 'X';	
				document.getElementById("ToMember").value = 'X';
			}   
		}
		/****************************
			submit and print functions 
		****************************/
		function printSubmit()
		{
			printLetter();
			releaseDirtyFlag();			
			submission();
		}

		function printLetter(){
			// hide the bottom buttons
			if (document.getElementById('BottomButtons').style.display == '')
				document.getElementById('BottomButtons').style.display = 'none';
			// print the letter
			window.print();
		} 

		function submission()
		{
			setFlag();
			setTimeout('document.twoPageForm.submit()',1000);			
		}

		function setFlag()
{
		// indicate that the form has been submitted
		if (document.getElementById("newForm").value == 'True')
			document.getElementById("newForm").value = 'False';
		}
		
		function showButtons()
		{
			//show the bottom buttons if they are hidden
			if (document.getElementById('BottomButtons').style.display == 'none')
				document.getElementById('BottomButtons').style.display = '';
		}
	</script>




<!-- scripts to confirm closing of window if it hadn't been saved yet -->
<script language="javascript">
//keypress events trigger dirty flag
var needToConfirm = false;
document.onkeyup=setDirtyFlag;
function setDirtyFlag(){
		needToConfirm = true;
}
function releaseDirtyFlag(){
		needToConfirm = false; //Call this function if doesn't requires an alert.
//this could be called when save button is clicked
}
window.onbeforeunload = confirmExit;
function confirmExit(){
	 if (needToConfirm){
		 return "You have attempted to leave this page. If you have made any changes to the fields without clicking the Save button, your changes will be lost. Are you sure you want to exit this page?";
	 }
}
</script>

<!-------Script to optimize window on loading----------->
<script language="JavaScript">
top.window.moveTo(0,0);
if (document.all) {
top.window.resizeTo(screen.availWidth,screen.availHeight);
}
else if (document.layers||document.getElementById) {
if (top.window.outerHeight<screen.availHeight||top.window.outerWidth<screen.availWidth){
top.window.outerHeight = screen.availHeight;
top.window.outerWidth = 850;
}
}
</script>
<!----------End optimize window script---------->






<!-- --Script for pop-up menu------------------- -->
<style type="text/css">
#topbar{
	position:absolute;
	border: 1px solid black;
	padding: 2px;
	background-color: lightyellow;
	width: 220px;
	visibility: hidden;
	z-index: 100;
	font-size: 14;
}
</style>

<script type="text/javascript">

/***********************************************
* Floating Top Bar script- u00A9 Dynamic Drive (www.dynamicdrive.com)
* Sliding routine by Roy Whittle (http://www.javascript-fx.com/)
* This notice must stay intact for legal use.
* Visit http://www.dynamicdrive.com/ for full source code
***********************************************/

var persistclose=0 //set to 0 or 1. 1 means once the bar is manually closed, it will remain closed for browser session
var startX = 760 //set x offset of bar in pixels
var startY = 0//set y offset of bar in pixels
var verticalpos="fromtop" //enter "fromtop" or "frombottom"

function iecompattest(){
	return (document.compatMode && document.compatMode!="BackCompat")? document.documentElement : document.body
}

function get_cookie(Name) {
	var search = Name + "="
	var returnvalue = "";
	if (document.cookie.length > 0) {
	offset = document.cookie.indexOf(search)
	if (offset != -1) {
	offset += search.length
	end = document.cookie.indexOf(";", offset);
	if (end == -1) end = document.cookie.length;
	returnvalue=unescape(document.cookie.substring(offset, end))
}
}
return returnvalue;
}

function closebar(){
	if (persistclose)
	document.cookie="remainclosed=1"
	document.getElementById("topbar").style.visibility="hidden"
	document.getElementById("topbar").style.display="none"
}

function staticbar(){
	barheight=document.getElementById("topbar").offsetHeight
	var ns = (navigator.appName.indexOf("Netscape") != -1) || window.opera;
	var d = document;
function ml(id){
	var el=d.getElementById(id);
	if (!persistclose || persistclose && get_cookie("remainclosed")=="")
		el.style.visibility="visible"
		if(d.layers)el.style=el;
		el.sP=function(x,y){this.style.left=x+"px";this.style.top=y+"px";};
		el.x = startX;
		if (verticalpos=="fromtop")
			el.y = startY;
		else{
			el.y = ns ? pageYOffset + innerHeight : iecompattest().scrollTop + iecompattest().clientHeight;
			el.y -= startY;
		}
		return el;
	}
	window.stayTopLeft=function(){
		if (verticalpos=="fromtop"){
			var pY = ns ? pageYOffset : iecompattest().scrollTop;
			ftlObj.y += (pY + startY - ftlObj.y)/8;
		}
		else{
			var pY = ns ? pageYOffset + innerHeight - barheight: iecompattest().scrollTop + iecompattest().clientHeight - barheight;
			ftlObj.y += (pY - startY - ftlObj.y)/8;
		}
		ftlObj.sP(ftlObj.x, ftlObj.y);
		setTimeout("stayTopLeft()", 10);
	}
	ftlObj = ml("topbar");
	stayTopLeft();
}

if (window.addEventListener)
	window.addEventListener("load", staticbar, false)
	else if (window.attachEvent)
		window.attachEvent("onload", staticbar)
	else if (document.getElementById)
		window.onload=staticbar
</script>

	
</HEAD>


<body onload="startUp();" onMouseDown="showButtons();">

<form method="post" action="" name="twoPageForm" id="twoPageForm">

<div id="page1" style="position: relative; left: 0px; top: 0px; width:750px;" class="pagebreak">

<img id='BGImage' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">

<!-- START OF DATABASE PLACEHOLDERS -->

<input type="hidden" name="clinic_name" id="clinic_name" oscarDB=clinic_name>
<input type="hidden" name="clinic_address" id="clinic_address" oscarDB=clinic_address>
<input type="hidden" name="clinic_addressLine" id="clinic_addressLine" oscarDB=clinic_addressLine>
<input type="hidden" name="clinic_addressLineFull" id="clinic_addressLineFull" oscarDB=clinic_addressLineFull>
<input type="hidden" name="clinic_label" id="clinic_label" oscarDB=clinic_label>
<input type="hidden" name="clinic_fax" id="clinic_fax" oscarDB=clinic_fax>
<input type="hidden" name="clinic_phone" id="clinic_phone" oscarDB=clinic_phone>
<input type="hidden" name="clinic_city" id="clinic_city" oscarDB=clinic_city>
<input type="hidden" name="clinic_province" id="clinic_province" oscarDB=clinic_province>
<input type="hidden" name="clinic_postal" id="clinic_postal" oscarDB=clinic_postal>

<input type="hidden" name="patient_name" id="patient_name" oscarDB=patient_name>
<input type="hidden" name="first_last_name" id="first_last_name" oscarDB=first_last_name>
<input type="hidden" name="patient_nameF" id="patient_nameF" oscarDB=patient_nameF >
<input type="hidden" name="patient_nameL" id="patient_nameL" oscarDB=patient_nameL >
<input type="hidden" name="label" id="label" oscarDB=label>
<input type="hidden" name="NameAddress" id="NameAddress" oscarDB=NameAddress>
<input type="hidden" name="address" id="address" oscarDB=address>
<input type="hidden" name="addressline" id="addressline" oscarDB=addressline>
<input type="hidden" name="phone" id="phone" oscarDB=phone>
<input type="hidden" name="phone2" id="phone2" oscarDB=phone2>
<input type="hidden" name="province" id="province" oscarDB=province>
<input type="hidden" name="city" id="city" oscarDB=city>
<input type="hidden" name="postal" id="postal" oscarDB=postal>
<input type="hidden" name="dob" id="dob" oscarDB=dob>
<input type="hidden" name="dobc" id="dobc" oscarDB=dobc>
<input type="hidden" name="dobc2" id="dobc2" oscarDB=dobc2>
<input type="hidden" name="hin" id="hin" oscarDB=hin>
<input type="hidden" name="hinc" id="hinc" oscarDB=hinc>
<input type="hidden" name="hinversion" id="hinversion" oscarDB=hinversion>
<input type="hidden" name="ageComplex" id="ageComplex" oscarDB=ageComplex >
<input type="hidden" name="age" id="age" oscarDB=age >
<input type="hidden" name="sex" id="sex" oscarDB=sex >
<input type="hidden" name="chartno" id="chartno" oscarDB=chartno >

<input type="hidden" name="medical_history" id="medical_history" oscarDB=medical_history>
<input type="hidden" name="recent_rx" id="recent_rx" oscarDB=recent_rx>
<input type="hidden" name="druglist_generic" id="druglist_generic" oscarDB=druglist_generic>
<input type="hidden" name="druglist_trade" id="druglist_trade" oscarDB=druglist_trade>
<input type="hidden" name="druglist_line" id="druglist_line" oscarDB=druglist_line>
<input type="hidden" name="social_family_history" id="social_family_history" oscarDB=social_family_history>
<input type="hidden" name="other_medications_history" id="other_medications_history" oscarDB=other_medications_history>
<input type="hidden" name="reminders" id="reminders" oscarDB=reminders>
<input type="hidden" name="ongoingconcerns" id="ongoingconcerns" oscarDB=ongoingconcerns >

<input type="hidden" name="provider_name_first_init" id="provider_name_first_init" oscarDB=provider_name_first_init >
<input type="hidden" name="current_user" id="current_user" oscarDB=current_user >
<input type="hidden" name="doctor_work_phone" id="doctor_work_phone" oscarDB=doctor_work_phone >
<input type="hidden" name="doctor" id="doctor" oscarDB=doctor >

<input type="hidden" name="today" id="today" oscarDB=today>

<input type="hidden" name="allergies_des" id="allergies_des" oscarDB=allergies_des >

<!-- PLACE REFERRAL PLACEHOLDERS HERE WHEN BC APCONFIG FIXED -->

<input type="hidden" name="referral_name" id="referral_name" oscarDB=referral_name>

<input type="hidden" name="referral_phone" id="referral_phone" oscarDB=referral_phone>

<input type="hidden" name="referral_fax" id="referral_fax" oscarDB=referral_fax>




<!-- END OF DATABASE PLACEHOLDERS -->


<!-- START OF MEASUREMENTS PLACEHOLDERS -->

<input type="hidden" name="BP" id="BP" oscarDB=m$BP#value>
<input type="hidden" name="WT" id="WT" oscarDB=m$WT#value>
<input type="hidden" name="HT" id="HT" oscarDB=m$HT#value>
<input type="hidden" name="BMI" id="BMI" oscarDB=mBMI#value>
<input type="hidden" name="smoker" id="smoker" oscarDB=m$SMK#value>
<input type="hidden" name="dailySmokes" id="dailySmokes" oscarDB=m$NOSK#value>
<input type="hidden" name="A1C" id="A1C" oscarDB=m$A1C#value>
<input type="hidden" name="LMP" id="LMP" oscarDB=m$LMP#value>
<input type="hidden" name="EDD" id="EDD" oscarDB=m$EDD#value>

<!-- END OF MEASUREMENTS PLACEHOLDERS -->


<!-- START OF DERIVED PLACEHOLDERS -->

<input type="hidden" name="he_she" id="he_she" value="he">
<input type="hidden" name="his_her" id="his_her" value="his">
<input type="hidden" name="gender" id="gender" value="male">
<input type="hidden" name="referral_nameL" id="referral_nameL" value="Referring Doctor">
<input type="hidden" name="letterhead" id="letterhead" value="Letterhead">

<!-- END OF DERIVED PLACEHOLDERS -->



<div style="position: absolute; left:100px; top: 50px; font-size:40px; font-family:Edwardian Script ITC; ">
<b>Generic Doctor</b>
</div>

<div style="position: absolute; left:435px; top: 68px; font-size:18px; font-family:Edwardian Script ITC; ">
<b>B.Sc., M.Sc., M.D., CCFP</b>
</div>

<div style="position: absolute; left:100px; top: 100px; font-size:15px; font-family:Times New Roman; ">
<span>Generic Doctor M.D. Inc.</span>
</div>

<div style="position: absolute; left:100px; top: 125px; font-size:15px; font-family:Times New Roman; ">
<span>Family Physician</span>
</div>



<div id="page1" style="position: absolute; left:100px; top:80px; font-size: 15px; font-family:Times New Roman; ">
<text>_______________________________________________________________________</text>
</div>


<div id="page1" style="position: absolute; left:400px; top:100px; ">
<textarea name="ClinicAddress" class="noborder" style="height: 60; width: 270; font-size: 15px; font-family:Times New Roman; text-align: right;" oscarDB=clinic_address></textarea>
</div>

<div id="page1" style="position: absolute; left:510px; top:180px; font-size: 15px; font-family:Times New Roman; ">
<text>Phone</text>
</div>


<div id="page1" style="position: absolute; left:560px; top:180px; ">
        <input name="clinicphone" type="text" class="noborder" style="width: 110px; font-family: Times New Roman; font-size: 15px; text-align: right;" oscardb=clinic_phone >
</div>


<div id="page1" style="position: absolute; left:510px; top:200px; font-size: 15px; font-family:Times New Roman; ">
<text>Fax</text>
</div>


<div id="page1" style="position: absolute; left:560px; top:200px; ">
        <input name="clinicfax" type="text" class="noborder" style="width: 110px; font-family: Times New Roman; font-size: 15px; text-align: right;" oscardb=clinic_fax >
</div>


<input name="TodaysDate" id="TodaysDate" type="text" class="noborder" style="position: absolute; left: 100px; top: 200px;  width: 70px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >

<textarea name="ReferralMD" id="ReferralMD" type="text" class="noborder" style="position: absolute; left:100px; top:225px;  height: 90px; width: 300px; font-family: Times New Roman; font-size: 15px; text-align: left;" value=referralMD3lineaddress>address block</textarea>

<div style="position: absolute; left:130px; top:320px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname" type="text" class="noborder" style="position: absolute; left:155px; top:319px; width: 220px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >

<div style="position: absolute; left:395px; top:320px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc" id="dobc" type="text" class="noborder" style="position: absolute; left:432px; top:319px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:345px; font-size: 15px; font-family:Times New Roman; ">
<span>Dear</span>
</div>

<input name="ReferralMDname" id="ReferralMDname" type="text" class="noborder" style="position: absolute; left:135px; top:344px; width: 180px; font-family: Times New Roman; font-size: 15px; text-align: left;" value=Addressee >

<textarea name="letterbody" id="letterbody" type="text" class="noborder" style="position: absolute; left:100px; top:365px; height: 600px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value=letterbody>Letter Body</textarea>

</div>

<div class="DoNotPrint" id="control1" style="position:absolute; top:20px; left: 760px;">

<input type="button" class="butn" name="AddLabel" id="AddLabel" value="Patient Block" 
	onClick="document.twoPageForm.letterbody.value +=document.getElementById('label').value; ">

<br>

<input type="button"  class="butn" name="AddMedicalHistory" value="Full History" width=30
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('medical_history').value; ">
<br>
<input type="button" class="butn" name="RecentMedications" id="RecentMedications" value="Recent Prescriptions"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('recent_rx').value;">
<br>
<input type="button" class="butn" name="Medlist" id="Medlist" value="Medication List"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('druglist_trade').value;">
<br>
<input type="button" class="butn" name="Allergies" id="Allergies" value="Allergies"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('allergies_des').value; ">
<br>
<input type="button" class="butn" name="AddOtherMedicationsHistory" value="Other Medications"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('other_medications_history').value; ">

<br>
<input type="button" class="butn" name="AddSocialFamilyHistory" value="Social and Family History" 
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('social_family_history').value;">
<br>
<input type="button" class="butn" name="AddReminders" value="Reminders"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('reminders').value;">
<br>
<input type="button" class="butn" name="AddOngoingConcerns" value="Ongoing Concerns"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('ongoingconcerns').value;">
<br>
<br>
<input type="button" class="butn" name="Patient" value="Patient F L Name"
	onclick=" document.twoPageForm.letterbody.value +=document.getElementById('first_last_name').value;">

<br>
<input type="button" class="butn" name="PatientAge" value="Patient Age"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('ageComplex').value; ">
<br>

<input type="button" class="butn" name="PatientSex" value="Patient Gender"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('sex').value;">
<br>
<br>
<input type="button" class="butn" name="Closing" value="Closing Salutation" 
	onclick=" document.twoPageForm.letterbody.value += '\n Yours Sincerely \n &nbsp; \n' + document.getElementById('provider_name_first_init').value+', MD';">
 
<br>
<input type="button" class="butn" name="User" value="Current User"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('current_user').value; ">
 
<br>
<input type="button" class="butn" name="Doctor" value="Attending Doctor"
	onclick="document.twoPageForm.letterbody.value +=document.getElementById('doctor').value;">
<br>
<br>
<input type="button" class="butn" name="AddBP" value="BP"
	onclick="document.twoPageForm.letterbody.value +=  '&nbsp;' + document.getElementById('BP').value;">
<br>
<input type="button" class="butn" name="AddWT" value="WT"
	onclick="document.twoPageForm.letterbody.value +=  '&nbsp;' + document.getElementById('WT').value+'Kg';">
<br>
<input type="button" class="butn" name="AddHT" value="HT"
	onclick="document.twoPageForm.letterbody.value += '&nbsp;' + document.getElementById('HT').value+'cm';">
<br>
<input type="button" class="butn" name="AddBMI" value="BMI"
	onclick="document.twoPageForm.letterbody.value += '&nbsp;' + document.getElementById('BMI').value+'Kg/m2';">
<br>
<input type="button" class="butn" name="AddA1C" value="A1C"
	onclick="document.twoPageForm.letterbody.value += '&nbsp;' + document.getElementById('A1C').value;">
<br>
<input type="button" class="butn" name="AddLMP" value="LMP"
	onclick="document.twoPageForm.letterbody.value += '&nbsp; Her last menstrual period was ' + document.getElementById('LMP').value+'&nbsp;(yyyy-mm-dd)';">
<br>
<input type="button" class="butn" name="AddEDD" value="EDD"
	onclick="document.twoPageForm.letterbody.value += '&nbsp; Her estimated date of delivery is ' + document.getElementById('EDD').value+'&nbsp;(yyyy-mm-dd)';">
<br>

<input type="button" class="butn" name="Qualified" value="Qualified"
	onclick="document.twoPageForm.letterbody.value += 'I am a duly qualified medical practitioner licensed to practice within Province, Canada.  I completed medical school in Year at Generic University in City, Province.  Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year.  I also did an additional six months of training through University Name in the area of Program in Year.  Prior to this, I received a Degree from the University of Province in Year and a Degree in Program at Impressive University in Year.  I have completed the LMCC 1 and 11, as well as the Canadian College of Family Practice board Examinations in Year.  I have been in practice in my permanent office since Month Day Year.';">

<input type="button" class="butn" name="Expert" value="Expert"
	onclick="document.twoPageForm.letterbody.value += 'I certify that my duty as an expert witness is to assist the court and that I must not be an advocated for any party when giving my opinion in court. I further certify that I have made this report in conformity with that duty and I will, if called on to give any oral or written testimony, do so in conformity with said duty. I have received no instructions in relation to the proceedings except for request by council to outline the original and ongoing emotional and physical effects of the motor vehicle accident. I am assuming that the patient has no secondary gain involved in the reporting of symptoms and that the history has been relayed to me as precisely as possible. In producing this report I had access to my office notes, reports from consultants, physiotherapy and x-ray. I will review available past history, presentation and changes in all aspects of health status, including when possible my assessment of prognosis.' ;">
<br>

<input type="button" class="butn" name="ProgressNotes" value="ProgressNotesDisclaim"
	onclick="document.twoPageForm.letterbody.value +='With regards to the clinical progress noted you should be aware that these are usually jotted down by myself, in haste, and they serve as an aide memoir to me for clinical management of the patient&rsquo;s condition. As such, these notes do not serve as minutes for the entire encounter with the patient that day. Due to the pressures of my clinical workload, not to mention overhead considerations, these notes are usually handwritten and may be quite illegible to you. These notes may even be deficient in total complaints submitted by the patient by the patient, or negative examination finds on clinical examination.';">
<br>

<input type="button" class="butn" name="CV" value="CV"
	onclick="document.twoPageForm.letterbody.value += 'Licensed Family Practice Physician with a special interest and training in Area 1. Strong academic and practical background in Area 2,3 & 4. Additional residency training in SubSpecialty 1 & 2. \n \n EDUCATION \n \n University of Province, Year \n &nbsp;&nbsp;&nbsp; Residency Training in SubSpecialty 1 & 2 \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; 	City Family Practice Residency Program \n Generic University, Year-Year \n &nbsp;&nbsp;&nbsp; M.D. Program \n Impressive University, Year-Year \n &nbsp;&nbsp;&nbsp; Degree in Field \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; Degree with honors in Field \n \n ASSOCIATIONS \n College of Physicians and Surgeons of Province \n Province Medical Associations \n \n CERTIFICATION \n Canadian College of Physicians and Surgeons (CCFP) \n LMCC I and II \n Neonatal Advances Life Support (NALS) \n Advanced Cardiac Life Support (ACLS) \n Advanced Trauma Life Support (ATLS) \n I am a duly qualified medical practitioner licensed to practice within Province, Canada. I completed medical school in Year at Generic University in City, Province. Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year. I did an additional six months of training through University Name in the area of Program in Year. Prior to this, I received a Degree in Field at Impressive University in Year. I have completed the LMCC I and II, as well as the Canadian College of Family Practice Board Examinations. I have been in practice in my permanent office since Month Day Year.  \n \n The majority of my practice consists of family medicine with additional interest 1, interest 2, interest 3; I was the Position at the City General Hospital unit Year - Year. I have been teaching in the City Residency program since Year, and teaching medical students since Year. ';">
<br>



<br>
</div>


<div id="page2" style="page-break-after:always; position: relative;" >

<img id='BGImage2' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate2" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname2" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc2" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody2" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>


<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.2</u></b>
</div>



</div>

<div class="DoNotPrint" id="control2" style="position:absolute; top:1040px; left: 760px;">

<input type="button" class="butn" name="AddLabel2" id="AddLabel2" value="Patient Block" 
	onClick="document.twoPageForm.letterbody2.value +=document.getElementById('label').value; ">

<br>

<input type="button"  class="butn" name="AddMedicalHistory2" value="Full History" width=30
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('medical_history').value; ">
<br>
<input type="button" class="butn" name="RecentMedications2" id="RecentMedications" value="Recent Prescriptions"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('recent_rx').value;">
<br>
<input type="button" class="butn" name="Medlist2" id="Medlist2" value="Medication List"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('druglist_trade').value;">
<br>
<input type="button" class="butn" name="Allergies2" id="Allergies2" value="Allergies"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('allergies_des').value; ">
<br>
<input type="button" class="butn" name="AddOtherMedicationsHistory2" value="Other Medications"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('other_medications_history').value; ">

<br>
<input type="button" class="butn" name="AddSocialFamilyHistory2" value="Social and Family History" 
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('social_family_history').value;">
<br>
<input type="button" class="butn" name="AddReminders2" value="Reminders"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('reminders').value;">
<br>
<input type="button" class="butn" name="AddOngoingConcerns2" value="Ongoing Concerns"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('ongoingconcerns').value;">
<br>
<br>
<input type="button" class="butn" name="Patient2" value="Patient F L Name"
	onclick=" document.twoPageForm.letterbody2.value +=document.getElementById('first_last_name').value;">

<br>
<input type="button" class="butn" name="PatientAge2" value="Patient Age"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('ageComplex').value; ">
<br>

<input type="button" class="butn" name="PatientSex" value="Patient Gender"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('sex').value;">
<br>
<br>
<input type="button" class="butn" name="Closing2" value="Closing Salutation" 
	onclick=" document.twoPageForm.letterbody2.value +='\n Yours Sincerely \n &nbsp; \n' + document.getElementById('provider_name_first_init').value+', MD';">
 
<br>
<input type="button" class="butn" name="User2" value="Current User"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('current_user').value; ">
 
<br>
<input type="button" class="butn" name="Doctor2" value="Attending Doctor"
	onclick="document.twoPageForm.letterbody2.value +=document.getElementById('doctor').value;">
<br>
<br>

<input type="button" class="butn" name="AddBP2" value="BP"
	onclick="document.twoPageForm.letterbody2.value += '&nbsp;' + document.getElementById('BP').value;">
<br>
<input type="button" class="butn" name="AddWT2" value="WT"
	onclick="document.twoPageForm.letterbody2.value += '&nbsp;' + document.getElementById('WT').value+'Kg';">
<br>
<input type="button" class="butn" name="AddHT2" value="HT"
	onclick="document.twoPageForm.letterbody2.value += '&nbsp;' + document.getElementById('HT').value+'cm';">
<br>
<input type="button" class="butn" name="AddBMI2" value="BMI"
	onclick="document.twoPageForm.letterbody2.value += '&nbsp;' + document.getElementById('BMI').value+'Kg/m2';">
<br>
<input type="button" class="butn" name="AddA1C2" value="A1C"
	onclick="document.twoPageForm.letterbody2.value += '&nbsp;' + document.getElementById('A1C').value;">
<br>
<input type="button" class="butn" name="AddLMP2" value="LMP"
	onclick="document.twoPageForm.letterbody2.value += '&nbsp; Her last menstrual period was ' + document.getElementById('LMP').value+'&nbsp;(yyyy-mm-dd)';">
<br>
<input type="button" class="butn" name="AddEDD2" value="EDD"
	onclick="document.twoPageForm.letterbody2.value += '&nbsp; Her estimated date of delivery is ' + document.getElementById('EDD').value+'&nbsp;(yyyy-mm-dd)';">
<br>

<input type="button" class="butn" name="Qualified2" value="Qualified"
	onclick="document.twoPageForm.letterbody2.value += 'I am a duly qualified medical practitioner licensed to practice within Province, Canada.  I completed medical school in Year at Generic University in City, Province.  Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year.  I also did an additional six months of training through University Name in the area of Program in Year.  Prior to this, I received a Degree from the University of Province in Year and a Degree in Program at Impressive University in Year.  I have completed the LMCC 1 and 11, as well as the Canadian College of Family Practice board Examinations in Year.  I have been in practice in my permanent office since Month Day Year.';">

<input type="button" class="butn" name="Expert2" value="Expert"
	onclick="document.twoPageForm.letterbody2.value += 'I certify that my duty as an expert witness is to assist the court and that I must not be an advocated for any party when giving my opinion in court. I further certify that I have made this report in conformity with that duty and I will, if called on to give any oral or written testimony, do so in conformity with said duty. I have received no instructions in relation to the proceedings except for request by council to outline the original and ongoing emotional and physical effects of the motor vehicle accident. I am assuming that the patient has no secondary gain involved in the reporting of symptoms and that the history has been relayed to me as precisely as possible. In producing this report I had access to my office notes, reports from consultants, physiotherapy and x-ray. I will review available past history, presentation and changes in all aspects of health status, including when possible my assessment of prognosis.' ;">
<br>

<input type="button" class="butn" name="ProgressNotes2" value="ProgressNotesDisclaim"
	onclick="document.twoPageForm.letterbody2.value += 'With regards to the clinical progress noted you should be aware that these are usually jotted down by myself, in haste, and they serve as an aide memoir to me for clinical management of the patient&rsquo;s condition. As such, these notes do not serve as minutes for the entire encounter with the patient that day. Due to the pressures of my clinical workload, not to mention overhead considerations, these notes are usually handwritten and may be quite illegible to you. These notes may even be deficient in total complaints submitted by the patient by the patient, or negative examination finds on clinical examination.';">
<br>

<input type="button" class="butn" name="CV2" value="CV"
	onclick="document.twoPageForm.letterbody2.value += 'Licensed Family Practice Physician with a special interest and training in Area 1. Strong academic and practical background in Area 2,3 & 4. Additional residency training in SubSpecialty 1 & 2. \n \n EDUCATION \n \n University of Province, Year \n &nbsp;&nbsp;&nbsp; Residency Training in SubSpecialty 1 & 2 \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; 	City Family Practice Residency Program \n Generic University, Year-Year \n &nbsp;&nbsp;&nbsp; M.D. Program \n Impressive University, Year-Year \n &nbsp;&nbsp;&nbsp; Degree in Field \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; Degree with honors in Field \n \n ASSOCIATIONS \n College of Physicians and Surgeons of Province \n Province Medical Associations \n \n CERTIFICATION \n Canadian College of Physicians and Surgeons (CCFP) \n LMCC I and II \n Neonatal Advances Life Support (NALS) \n Advanced Cardiac Life Support (ACLS) \n Advanced Trauma Life Support (ATLS) \n I am a duly qualified medical practitioner licensed to practice within Province, Canada. I completed medical school in Year at Generic University in City, Province. Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year. I did an additional six months of training through University Name in the area of Program in Year. Prior to this, I received a Degree in Field at Impressive University in Year. I have completed the LMCC I and II, as well as the Canadian College of Family Practice Board Examinations. I have been in practice in my permanent office since Month Day Year.  \n \n The majority of my practice consists of family medicine with additional interest 1, interest 2, interest 3; I was the Position at the City General Hospital unit Year - Year. I have been teaching in the City Residency program since Year, and teaching medical students since Year. ';">
<br>




<br>
</div>

<div id="page3" style="page-break-after:always; position: relative;" >

<img id='BGImage3' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate3" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname3" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc3" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody3" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.3</u></b>
</div>



</div>

<div class="DoNotPrint" id="control3" style="position:absolute; top:2100px; left: 760px;">

<input type="button" class="butn" name="AddLabel3" id="AddLabel3" value="Patient Block" 
	onClick="document.twoPageForm.letterbody3.value +=document.getElementById('label').value; ">

<br>

<input type="button"  class="butn" name="AddMedicalHistory3" value="Full History" width=30
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('medical_history').value; ">
<br>
<input type="button" class="butn" name="RecentMedications3" id="RecentMedications" value="Recent Prescriptions"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('recent_rx').value;">
<br>
<input type="button" class="butn" name="Medlist3" id="Medlist3" value="Medication List"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('druglist_trade').value;">
<br>
<input type="button" class="butn" name="Allergies3" id="Allergies3" value="Allergies"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('allergies_des').value; ">
<br>
<input type="button" class="butn" name="AddOtherMedicationsHistory3" value="Other Medications"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('other_medications_history').value; ">

<br>
<input type="button" class="butn" name="AddSocialFamilyHistory3" value="Social and Family History" 
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('social_family_history').value;">
<br>
<input type="button" class="butn" name="AddReminders3" value="Reminders"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('reminders').value;">
<br>
<input type="button" class="butn" name="AddOngoingConcerns3" value="Ongoing Concerns"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('ongoingconcerns').value;">
<br>
<br>
<input type="button" class="butn" name="Patient3" value="Patient F L Name"
	onclick=" document.twoPageForm.letterbody3.value +=document.getElementById('first_last_name').value;">

<br>
<input type="button" class="butn" name="PatientAge3" value="Patient Age"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('ageComplex').value; ">
<br>

<input type="button" class="butn" name="PatientSex" value="Patient Gender"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('sex').value;">
<br>
<br>
<input type="button" class="butn" name="Closing3" value="Closing Salutation" 
	onclick=" document.twoPageForm.letterbody3.value +='\n Yours Sincerely \n &nbsp; \n' + document.getElementById('provider_name_first_init').value+', MD';">
 
<br>
<input type="button" class="butn" name="User3" value="Current User"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('current_user').value; ">
 
<br>
<input type="button" class="butn" name="Doctor3" value="Attending Doctor"
	onclick="document.twoPageForm.letterbody3.value +=document.getElementById('doctor').value;">
<br>
<br>

<input type="button" class="butn" name="AddBP3" value="BP"
	onclick="document.twoPageForm.letterbody3.value += '&nbsp;' + document.getElementById('BP').value;">
<br>
<input type="button" class="butn" name="AddWT3" value="WT"
	onclick="document.twoPageForm.letterbody3.value += '&nbsp;' + document.getElementById('WT').value+'Kg';">
<br>
<input type="button" class="butn" name="AddHT3" value="HT"
	onclick="document.twoPageForm.letterbody3.value += '&nbsp;' + document.getElementById('HT').value+'cm';">
<br>
<input type="button" class="butn" name="AddBMI3" value="BMI"
	onclick="document.twoPageForm.letterbody3.value += '&nbsp;' + document.getElementById('BMI').value+'Kg/m2';">
<br>
<input type="button" class="butn" name="AddA1C3" value="A1C"
	onclick="document.twoPageForm.letterbody3.value += '&nbsp;' + document.getElementById('A1C').value;">
<br>
<input type="button" class="butn" name="AddLMP3" value="LMP"
	onclick="document.twoPageForm.letterbody3.value += '&nbsp; Her last menstrual period was ' + document.getElementById('LMP').value+'&nbsp;(yyyy-mm-dd)';">
<br>
<input type="button" class="butn" name="AddEDD3" value="EDD"
	onclick="document.twoPageForm.letterbody3.value += '&nbsp; Her estimated date of delivery is ' + document.getElementById('EDD').value+'&nbsp;(yyyy-mm-dd)';">
<br>

<input type="button" class="butn" name="Qualified3" value="Qualified"
	onclick="document.twoPageForm.letterbody3.value += 'I am a duly qualified medical practitioner licensed to practice within Province, Canada.  I completed medical school in Year at Generic University in City, Province.  Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year.  I also did an additional six months of training through University Name in the area of Program in Year.  Prior to this, I received a Degree from the University of Province in Year and a Degree in Program at Impressive University in Year.  I have completed the LMCC 1 and 11, as well as the Canadian College of Family Practice board Examinations in Year.  I have been in practice in my permanent office since Month Day Year.';">

<input type="button" class="butn" name="Expert3" value="Expert"
	onclick="document.twoPageForm.letterbody3.value += 'I certify that my duty as an expert witness is to assist the court and that I must not be an advocated for any party when giving my opinion in court. I further certify that I have made this report in conformity with that duty and I will, if called on to give any oral or written testimony, do so in conformity with said duty. I have received no instructions in relation to the proceedings except for request by council to outline the original and ongoing emotional and physical effects of the motor vehicle accident. I am assuming that the patient has no secondary gain involved in the reporting of symptoms and that the history has been relayed to me as precisely as possible. In producing this report I had access to my office notes, reports from consultants, physiotherapy and x-ray. I will review available past history, presentation and changes in all aspects of health status, including when possible my assessment of prognosis.' ;">
<br>

<input type="button" class="butn" name="ProgressNotes3" value="ProgressNotesDisclaim"
	onclick="document.twoPageForm.letterbody3.value += 'With regards to the clinical progress noted you should be aware that these are usually jotted down by myself, in haste, and they serve as an aide memoir to me for clinical management of the patient&rsquo;s condition. As such, these notes do not serve as minutes for the entire encounter with the patient that day. Due to the pressures of my clinical workload, not to mention overhead considerations, these notes are usually handwritten and may be quite illegible to you. These notes may even be deficient in total complaints submitted by the patient by the patient, or negative examination finds on clinical examination.';">
<br>

<input type="button" class="butn" name="CV3" value="CV"
	onclick="document.twoPageForm.letterbody3.value += 'Licensed Family Practice Physician with a special interest and training in Area 1. Strong academic and practical background in Area 2,3 & 4. Additional residency training in SubSpecialty 1 & 2. \n \n EDUCATION \n \n University of Province, Year \n &nbsp;&nbsp;&nbsp; Residency Training in SubSpecialty 1 & 2 \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; 	City Family Practice Residency Program \n Generic University, Year-Year \n &nbsp;&nbsp;&nbsp; M.D. Program \n Impressive University, Year-Year \n &nbsp;&nbsp;&nbsp; Degree in Field \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; Degree with honors in Field \n \n ASSOCIATIONS \n College of Physicians and Surgeons of Province \n Province Medical Associations \n \n CERTIFICATION \n Canadian College of Physicians and Surgeons (CCFP) \n LMCC I and II \n Neonatal Advances Life Support (NALS) \n Advanced Cardiac Life Support (ACLS) \n Advanced Trauma Life Support (ATLS) \n I am a duly qualified medical practitioner licensed to practice within Province, Canada. I completed medical school in Year at Generic University in City, Province. Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year. I did an additional six months of training through University Name in the area of Program in Year. Prior to this, I received a Degree in Field at Impressive University in Year. I have completed the LMCC I and II, as well as the Canadian College of Family Practice Board Examinations. I have been in practice in my permanent office since Month Day Year.  \n \n The majority of my practice consists of family medicine with additional interest 1, interest 2, interest 3; I was the Position at the City General Hospital unit Year - Year. I have been teaching in the City Residency program since Year, and teaching medical students since Year. ';">
<br>




<br>

</div>

<div id="page4" style="page-break-after:always; position: relative;" >

<img id='BGImage4' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate4" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname4" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc4" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody4" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.4</u></b>
</div>



</div>

<div class="DoNotPrint" id="control4" style="position:absolute; top:3060px; left: 760px;">

<input type="button" class="butn" name="AddLabel4" id="AddLabel4" value="Patient Block" 
	onClick="document.twoPageForm.letterbody4.value +=document.getElementById('label').value; ">

<br>

<input type="button"  class="butn" name="AddMedicalHistory4" value="Full History" width=30
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('medical_history').value; ">
<br>
<input type="button" class="butn" name="RecentMedications4" id="RecentMedications" value="Recent Prescriptions"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('recent_rx').value;">
<br>
<input type="button" class="butn" name="Medlist4" id="Medlist4" value="Medication List"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('druglist_trade').value;">
<br>
<input type="button" class="butn" name="Allergies4" id="Allergies4" value="Allergies"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('allergies_des').value; ">
<br>
<input type="button" class="butn" name="AddOtherMedicationsHistory4" value="Other Medications"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('other_medications_history').value; ">

<br>
<input type="button" class="butn" name="AddSocialFamilyHistory4" value="Social and Family History" 
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('social_family_history').value;">
<br>
<input type="button" class="butn" name="AddReminders4" value="Reminders"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('reminders').value;">
<br>
<input type="button" class="butn" name="AddOngoingConcerns4" value="Ongoing Concerns"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('ongoingconcerns').value;">
<br>
<br>
<input type="button" class="butn" name="Patient4" value="Patient F L Name"
	onclick=" document.twoPageForm.letterbody4.value +=document.getElementById('first_last_name').value;">

<br>
<input type="button" class="butn" name="PatientAge4" value="Patient Age"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('ageComplex').value; ">
<br>

<input type="button" class="butn" name="PatientSex" value="Patient Gender"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('sex').value;">
<br>
<br>
<input type="button" class="butn" name="Closing4" value="Closing Salutation" 
	onclick=" document.twoPageForm.letterbody4.value +='\n Yours Sincerely \n &nbsp; \n' + document.getElementById('provider_name_first_init').value+', MD';">
 
<br>
<input type="button" class="butn" name="User4" value="Current User"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('current_user').value; ">
 
<br>
<input type="button" class="butn" name="Doctor4" value="Attending Doctor"
	onclick="document.twoPageForm.letterbody4.value +=document.getElementById('doctor').value;">
<br>
<br>

<input type="button" class="butn" name="AddBP4" value="BP"
	onclick="document.twoPageForm.letterbody4.value += '&nbsp;' + document.getElementById('BP').value;">
<br>
<input type="button" class="butn" name="AddWT4" value="WT"
	onclick="document.twoPageForm.letterbody4.value += '&nbsp;' + document.getElementById('WT').value+'Kg';">
<br>
<input type="button" class="butn" name="AddHT4" value="HT"
	onclick="document.twoPageForm.letterbody4.value += '&nbsp;' + document.getElementById('HT').value+'cm';">
<br>
<input type="button" class="butn" name="AddBMI4" value="BMI"
	onclick="document.twoPageForm.letterbody4.value += '&nbsp;' + document.getElementById('BMI').value+'Kg/m2';">
<br>
<input type="button" class="butn" name="AddA1C4" value="A1C"
	onclick="document.twoPageForm.letterbody4.value += '&nbsp;' + document.getElementById('A1C').value;">
<br>
<input type="button" class="butn" name="AddLMP4" value="LMP"
	onclick="document.twoPageForm.letterbody4.value += '&nbsp; Her last menstrual period was ' + document.getElementById('LMP').value+'&nbsp;(yyyy-mm-dd)';">
<br>
<input type="button" class="butn" name="AddEDD4" value="EDD"
	onclick="document.twoPageForm.letterbody4.value += '&nbsp; Her estimated date of delivery is ' + document.getElementById('EDD').value+'&nbsp;(yyyy-mm-dd)';">
<br>

<input type="button" class="butn" name="Qualified4" value="Qualified"
	onclick="document.twoPageForm.letterbody4.value += 'I am a duly qualified medical practitioner licensed to practice within Province, Canada.  I completed medical school in Year at Generic University in City, Province.  Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year.  I also did an additional six months of training through University Name in the area of Program in Year.  Prior to this, I received a Degree from the University of Province in Year and a Degree in Program at Impressive University in Year.  I have completed the LMCC 1 and 11, as well as the Canadian College of Family Practice board Examinations in Year.  I have been in practice in my permanent office since Month Day Year.';">

<input type="button" class="butn" name="Expert4" value="Expert"
	onclick="document.twoPageForm.letterbody4.value += 'I certify that my duty as an expert witness is to assist the court and that I must not be an advocated for any party when giving my opinion in court. I further certify that I have made this report in conformity with that duty and I will, if called on to give any oral or written testimony, do so in conformity with said duty. I have received no instructions in relation to the proceedings except for request by council to outline the original and ongoing emotional and physical effects of the motor vehicle accident. I am assuming that the patient has no secondary gain involved in the reporting of symptoms and that the history has been relayed to me as precisely as possible. In producing this report I had access to my office notes, reports from consultants, physiotherapy and x-ray. I will review available past history, presentation and changes in all aspects of health status, including when possible my assessment of prognosis.' ;">
<br>

<input type="button" class="butn" name="ProgressNotes4" value="ProgressNotesDisclaim"
	onclick="document.twoPageForm.letterbody4.value += 'With regards to the clinical progress noted you should be aware that these are usually jotted down by myself, in haste, and they serve as an aide memoir to me for clinical management of the patient&rsquo;s condition. As such, these notes do not serve as minutes for the entire encounter with the patient that day. Due to the pressures of my clinical workload, not to mention overhead considerations, these notes are usually handwritten and may be quite illegible to you. These notes may even be deficient in total complaints submitted by the patient by the patient, or negative examination finds on clinical examination.';">
<br>

<input type="button" class="butn" name="CV4" value="CV"
	onclick="document.twoPageForm.letterbody4.value += 'Licensed Family Practice Physician with a special interest and training in Area 1. Strong academic and practical background in Area 2,3 & 4. Additional residency training in SubSpecialty 1 & 2. \n \n EDUCATION \n \n University of Province, Year \n &nbsp;&nbsp;&nbsp; Residency Training in SubSpecialty 1 & 2 \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; 	City Family Practice Residency Program \n Generic University, Year-Year \n &nbsp;&nbsp;&nbsp; M.D. Program \n Impressive University, Year-Year \n &nbsp;&nbsp;&nbsp; Degree in Field \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; Degree with honors in Field \n \n ASSOCIATIONS \n College of Physicians and Surgeons of Province \n Province Medical Associations \n \n CERTIFICATION \n Canadian College of Physicians and Surgeons (CCFP) \n LMCC I and II \n Neonatal Advances Life Support (NALS) \n Advanced Cardiac Life Support (ACLS) \n Advanced Trauma Life Support (ATLS) \n I am a duly qualified medical practitioner licensed to practice within Province, Canada. I completed medical school in Year at Generic University in City, Province. Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year. I did an additional six months of training through University Name in the area of Program in Year. Prior to this, I received a Degree in Field at Impressive University in Year. I have completed the LMCC I and II, as well as the Canadian College of Family Practice Board Examinations. I have been in practice in my permanent office since Month Day Year.  \n \n The majority of my practice consists of family medicine with additional interest 1, interest 2, interest 3; I was the Position at the City General Hospital unit Year - Year. I have been teaching in the City Residency program since Year, and teaching medical students since Year. ';">
<br>




<br>
</div>


<div id="page5" style="page-break-after:always; position: relative;" >

<img id='BGImage5' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate5" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname5" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc5" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody5" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.5</u></b>
</div>



</div>

<div class="DoNotPrint" id="control5" style="position:absolute; top:3060px; left: 760px;">

<input type="button" class="butn" name="AddLabel5" id="AddLabel5" value="Patient Block" 
	onClick="document.twoPageForm.letterbody5.value +=document.getElementById('label').value; ">

<br>

<input type="button"  class="butn" name="AddMedicalHistory5" value="Full History" width=30
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('medical_history').value; ">
<br>
<input type="button" class="butn" name="RecentMedications5" id="RecentMedications" value="Recent Prescriptions"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('recent_rx').value;">
<br>
<input type="button" class="butn" name="Medlist5" id="Medlist5" value="Medication List"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('druglist_trade').value;">
<br>
<input type="button" class="butn" name="Allergies5" id="Allergies5" value="Allergies"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('allergies_des').value; ">
<br>
<input type="button" class="butn" name="AddOtherMedicationsHistory5" value="Other Medications"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('other_medications_history').value; ">

<br>
<input type="button" class="butn" name="AddSocialFamilyHistory5" value="Social and Family History" 
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('social_family_history').value;">
<br>
<input type="button" class="butn" name="AddReminders5" value="Reminders"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('reminders').value;">
<br>
<input type="button" class="butn" name="AddOngoingConcerns5" value="Ongoing Concerns"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('ongoingconcerns').value;">
<br>
<br>
<input type="button" class="butn" name="Patient5" value="Patient F L Name"
	onclick=" document.twoPageForm.letterbody5.value +=document.getElementById('first_last_name').value;">

<br>
<input type="button" class="butn" name="PatientAge5" value="Patient Age"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('ageComplex').value; ">
<br>

<input type="button" class="butn" name="PatientSex" value="Patient Gender"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('sex').value;">
<br>
<br>
<input type="button" class="butn" name="Closing5" value="Closing Salutation" 
	onclick=" document.twoPageForm.letterbody5.value +='\n Yours Sincerely \n &nbsp; \n' + document.getElementById('provider_name_first_init').value+', MD';">
 
<br>
<input type="button" class="butn" name="User5" value="Current User"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('current_user').value; ">
 
<br>
<input type="button" class="butn" name="Doctor5" value="Attending Doctor"
	onclick="document.twoPageForm.letterbody5.value +=document.getElementById('doctor').value;">
<br>
<br>

<input type="button" class="butn" name="AddBP5" value="BP"
	onclick="document.twoPageForm.letterbody5.value += '&nbsp;' + document.getElementById('BP').value;">
<br>
<input type="button" class="butn" name="AddWT5" value="WT"
	onclick="document.twoPageForm.letterbody5.value += '&nbsp;' + document.getElementById('WT').value+'Kg';">
<br>
<input type="button" class="butn" name="AddHT5" value="HT"
	onclick="document.twoPageForm.letterbody5.value += '&nbsp;' + document.getElementById('HT').value+'cm';">
<br>
<input type="button" class="butn" name="AddBMI5" value="BMI"
	onclick="document.twoPageForm.letterbody5.value += '&nbsp;' + document.getElementById('BMI').value+'Kg/m2';">
<br>
<input type="button" class="butn" name="AddA1C5" value="A1C"
	onclick="document.twoPageForm.letterbody5.value += '&nbsp;' + document.getElementById('A1C').value;">
<br>
<input type="button" class="butn" name="AddLMP5" value="LMP"
	onclick="document.twoPageForm.letterbody5.value += '&nbsp; Her last menstrual period was ' + document.getElementById('LMP').value+'&nbsp;(yyyy-mm-dd)';">
<br>
<input type="button" class="butn" name="AddEDD5" value="EDD"
	onclick="document.twoPageForm.letterbody5.value += '&nbsp; Her estimated date of delivery is ' + document.getElementById('EDD').value+'&nbsp;(yyyy-mm-dd)';">
<br>

<input type="button" class="butn" name="Qualified5" value="Qualified"
	onclick="document.twoPageForm.letterbody5.value += 'I am a duly qualified medical practitioner licensed to practice within Province, Canada.  I completed medical school in Year at Generic University in City, Province.  Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year.  I also did an additional six months of training through University Name in the area of Program in Year.  Prior to this, I received a Degree from the University of Province in Year and a Degree in Program at Impressive  University in Year.  I have completed the LMCC 1 and 11, as well as the Canadian College of Family Practice board Examinations in Year.  I have been in practice in my permanent office since Month Day Year.';">

<input type="button" class="butn" name="Expert5" value="Expert"
	onclick="document.twoPageForm.letterbody5.value += 'I certify that my duty as an expert witness is to assist the court and that I must not be an advocated for any party when giving my opinion in court. I further certify that I have made this report in conformity with that duty and I will, if called on to give any oral or written testimony, do so in conformity with said duty. I have received no instructions in relation to the proceedings except for request by council to outline the original and ongoing emotional and physical effects of the motor vehicle accident. I am assuming that the patient has no secondary gain involved in the reporting of symptoms and that the history has been relayed to me as precisely as possible. In producing this report I had access to my office notes, reports from consultants, physiotherapy and x-ray. I will review available past history, presentation and changes in all aspects of health status, including when possible my assessment of prognosis.' ;">
<br>

<input type="button" class="butn" name="ProgressNotes5" value="ProgressNotesDisclaim"
	onclick="document.twoPageForm.letterbody5.value += 'With regards to the clinical progress noted you should be aware that these are usually jotted down by myself, in haste, and they serve as an aide memoir to me for clinical management of the patient&rsquo;s condition. As such, these notes do not serve as minutes for the entire encounter with the patient that day. Due to the pressures of my clinical workload, not to mention overhead considerations, these notes are usually handwritten and may be quite illegible to you. These notes may even be deficient in total complaints submitted by the patient by the patient, or negative examination finds on clinical examination.';">
<br>

<input type="button" class="butn" name="CV5" value="CV"
	onclick="document.twoPageForm.letterbody5.value += 'Licensed Family Practice Physician with a special interest and training in Area 1. Strong academic and practical background in Area 2,3 & 4. Additional residency training in SubSpecialty 1 & 2. \n \n EDUCATION \n \n University of Province, Year \n &nbsp;&nbsp;&nbsp; Residency Training in SubSpecialty 1 & 2 \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; 	City Family Practice Residency Program \n Generic University, Year-Year \n &nbsp;&nbsp;&nbsp; M.D. Program \n Impressive University, Year-Year \n &nbsp;&nbsp;&nbsp; Degree in Field \n University of Province, Year-Year \n &nbsp;&nbsp;&nbsp; Degree with honors in Field \n \n ASSOCIATIONS \n College of Physicians and Surgeons of Province \n Province Medical Associations \n \n CERTIFICATION \n Canadian College of Physicians and Surgeons (CCFP) \n LMCC I and II \n Neonatal Advances Life Support (NALS) \n Advanced Cardiac Life Support (ACLS) \n Advanced Trauma Life Support (ATLS) \n I am a duly qualified medical practitioner licensed to practice within Province, Canada. I completed medical school in Year at Generic University in City, Province. Following that, I underwent a Family Medicine Residency Program in City, through the University of Province, which I completed in Year. I did an additional six months of training through University Name in the area of Program in Year. Prior to this, I received a Degree in Field at Impressive University in Year. I have completed the LMCC I and II, as well as the Canadian College of Family Practice Board Examinations. I have been in practice in my permanent office since Month Day Year.  \n \n The majority of my practice consists of family medicine with additional interest 1, interest 2, interest 3; I was the Position at the City General Hospital unit Year - Year. I have been teaching in the City Residency program since Year, and teaching medical students since Year. ';">
<br>




<br>
</div>

<div id="page6" style="page-break-after:always; position: relative;" >

<img id='BGImage6' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate6" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname6" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc6" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody6" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.6</u></b>
</div>

</div>


<div id="page7" style="page-break-after:always; position: relative;" >

<img id='BGImage7' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate7" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname7" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc7" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody7" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.7</u></b>
</div>

</div>


<div id="page8" style="page-break-after:always; position: relative;" >

<img id='BGImage8' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate8" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname8" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc8" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody8" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.8</u></b>
</div>

</div>


<div id="page9" style="page-break-after:always; position: relative;" >

<img id='BGImage9' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate9" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname9" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc9" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody9" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.9</u></b>
</div>

</div>


<div id="page10" style="page-break-after:always; position: relative;" >

<img id='BGImage10' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate10" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname10" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc10" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody10" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.10</u></b>
</div>

</div>


<div id="page11" style="page-break-after:always; position: relative;" >

<img id='BGImage11' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate11" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname11" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc11" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody11" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.11</u></b>
</div>

</div>


<div id="page12" style="page-break-after:always; position: relative;" >

<img id='BGImage12' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate12" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname12" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc12" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody12" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.12</u></b>
</div>

</div>


<div id="page13" style="page-break-after:always; position: relative;" >

<img id='BGImage13' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate13" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname13" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc13" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody13" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.13</u></b>
</div>

</div>


<div id="page14" style="page-break-after:always; position: relative;" >

<img id='BGImage14' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate14" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname14" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc14" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody14" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.14</u></b>
</div>

</div>


<div id="page15" style="page-break-after:always; position: relative;" >

<img id='BGImage15' src="${oscar_image_path}BlankPage.png" style="position: relative; left: 0px; top: 0px; width:750px">



<input name="TodaysDate15" type="text" class="noborder" style="position: absolute; left: 100px; top: 100px; width: 80px; font-family: Times New Roman; font-size: 15px; text-align: left;" oscardb=today >


<div style="position: absolute; left:130px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>RE:</u></b>
</div>

<input name="patientname15" type="text" class="noborder" style="position: absolute; left:155px; top:139px; width: 200px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=patient_name >


<div style="position: absolute; left:395px; top:140px; font-size: 15px; font-family:Times New Roman; ">
<b><u>DOB:</u></b>
</div>

<input name="dobc15" type="text" class="noborder" style="position: absolute; left:432px; top:139px; width: 150px; font-family: Times New Roman; font-size: 15px; font-weight: bold; text-decoration: underline; text-align: left;" oscardb=dobc >

<div style="position: absolute; left:100px; top:180px; ">
<textarea name="letterbody15" type="text" class="noborder" style="height: 740px; width: 600px; font-family: Times New Roman; font-size: 15px; text-align: left;" value="">Letter Body</textarea>
</div>

<div style="position: absolute; left:700px; top:940px; font-size: 15px; font-family:Times New Roman; ">
<b><u>p.15</u></b>
</div>

</div>



		 <div class="DoNotPrint" id="BottomButtons">
			 <table>
			<tr><td>
				<input type="hidden" id="newForm" name="newForm" value="True" />				
				 Subject: <input name="subject" size="40" type="text"> 
					<input value="Submit" name="SubmitButton" id="SubmitButton" type="button" onclick="javascript:submission();"> 			
					<input value="Reset" name="ResetButton" id="ResetButton" type="reset"> 
					<input value="Print" name="PrintButton" id="PrintButton" type="button" onclick="printLetter()"> 			
					<input value="Print & Submit" name="PrintSubmitButton" id="PrintSubmitButton" type="button" onclick="printSubmit()"> 
			 </td></tr></table>
		 </div>







</form>
</BODY>
</HTML>

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