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医疗决策支持系统

            <td height="20" align="left" valign="top" class="FormInsideTableRegCell"><img src="../../Images/shim.gif" border="0" width="4" height="0">Pulse:</td>
            <td height="20" align="left" valign="top" class="FormInsideTableRegCell"><img src="../../Images/shim.gif" border="0" width="4" height="0">Temp:</td>
            <td height="20" align="left" valign="top" class="FormInsideTableRegCell"><img src="../../Images/shim.gif" border="0" width="4" height="0">Resp:</td>
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            <td height="22" align="left" valign="top" class="FormInsideTableRegCell"><img src="../../Images/shim.gif" border="0" width="4" height="0">KPS:</td>
            <td height="22" align="left" valign="top" class="FormInsideTableRegCell"><img src="../../Images/shim.gif" border="0" width="4" height="0">Height:</td>
            <td height="22" align="left" valign="top" class="FormInsideTableRegCell"><img src="../../Images/shim.gif" border="0" width="4" height="0">Weight:</td>
            <td height="22" align="left" valign="top" class="FormInsideTableRegCell"><img src="../../Images/shim.gif" border="0" width="4" height="0">BSA:</td>
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            <td height="20" colspan="4" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Physical Exam:</span></td>
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            <td  height="20" width="10%" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>General:</span></td>
            <td width="40%" class="FormInsideTableLeftCell">&nbsp;</td>
            <td  height="20" width="10%" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Abd/GI:</span></td>
            <td width="40%" class="FormInsideTableLeftCell">&nbsp;</td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Psych:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
            <td class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Rectal:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Eyes:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
            <td class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Neuro:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>ENT/Mouth:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
            <td class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>MS/Extr:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Nodes:</span></td>
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            <td class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Skin:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Lungs:</span></td>
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            <td class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>GU/GYN:</span></td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>CV:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
            <td class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="8" height="8"><span>Back:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Breasts:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
            <td class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Masses:</span></td>
            <td class="FormInsideTableLeftCell">&nbsp;</td>
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            <td  height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span>Other:</span></td>
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            <td height="20"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Comments \ Diagrams:</span></td>
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            <td height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Labs \ Imaging:</span></td>
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            <td height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Impressions:</span></td>
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            <td height="20" class="FormInnerRowBottomBorder"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Plan:</span></td>
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		 <td class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Signature</span><br>
		  <img src="../../Images/shim.gif" border="0" width="4" height="20"><span class="blackBoldText">Attending:<img src="../../Images/shim.gif" border="0" width="15" height="8">___________________________________________________________________</span>
		  
		  <asp:Label id="PhysicianSignatureLabel" runat="server" Font-Bold="true" ><br/><img src="../../Images/shim.gif" border="0" width="280" height="1"></asp:Label>

		  
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		<td class="FormOuterTableRow" align="center"><span class="blackBoldTextSmall">**Please verify that the service date is printed on each page**</span></td>
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      <td height="14" align="center" valign="bottom" class="blackBoldText">GU29<img src="../../images/shim.gif" border="0" width="45" height="1">U39<img src="../../images/shim.gif" border="0" width="45" height="1">CMIC 
        Approval Date: 6/05<img src="../../images/shim.gif" border="0" width="45" height="8"><!--rev:9/17/04--><img src="../../images/shim.gif" border="0" width="45" height="1">Page <span id="PageNumber">1</span> of <span id="TotalPages">1</span><img src="../../images/shim.gif" border="0" width="45" height="1">B/02.070.<span class="blackBoldTextSmall">29</span></td>
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