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Health Report for Admission to Long Term Care 2734-69

The purpose of this form is to provide information about the person who is applying for admission to a Long-Term Care facility. Install as per usual, uploading the html file as a form. Image files (.png) and style files (.css) need to be uploaded to the images folder.

print1.css

print2.css

output1.png

output2.png

2PageForm.html

CCAC eForm output part of page 1

Result form

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