Detected 6 occurrence(s) of ‘\bpatient\b(.|\b|\r){0,45}\b(id|dob|claim|NPI|record)\b': <font size="5"> <b>User Data<br><br> <font size="5"> Please Enter your data in the form below:</b><br><br> <font size="5"> <fieldset class="row1"> <table border="0"> <tr> <td><label>Patient ID</label>: </td> <td><input type="text" name="Patient ID" ></td> </tr> <tr> <td> <label>First name :</label></td> <td><input type="text" name="First Name" required placeholder="First name "> </td></tr> <tr> <td> <label>Last name: </label></td> <td> […]
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