| Parent File | Name | Number | Package |
|---|---|---|---|
| HEALTH SUMMARY PWH FORMS(#9001025.06) | FORM TEXT | 9001025.0611 | Patient Care Component |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | FORM TEXT | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************
|
| 11 | TEXT OF FORM | 11;0 | WORD-PROCESSING #9001025.061111 |