Parent File | Name | Number | Package |
---|---|---|---|
9000046.11 | ADDITIONAL DAYS AUTHORIZED | 9000046.1201 | IHS Patient |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | DATE AUTH OBTAINED | 0;1 | DATE |
|
.02 | REFERENCE NUMBER | 0;2 | FREE TEXT |
|
.03 | CONTACT PERSON | 0;3 | FREE TEXT |
|
.04 | CONTACT PHONE | 0;4 | FREE TEXT |
|
.05 | CONTACT E-MAIL | 0;5 | FREE TEXT |
|
.06 | CONTACT FAX | 0;6 | FREE TEXT |
|
.07 | NUMBER OF DAYS AUTHORIZED | 0;7 | NUMBER |
|
.08 | NUMBER OF VISITS AUTHORIZED | 0;8 | NUMBER |
|
101 | ADDITIONAL DAYS NOTES | 2;0 | WORD-PROCESSING #9000046.12201 |