﻿<?xml version="1.0" encoding="utf-8" ?>
<Form>
  <Table>
    <tr>
      <td type="table" height="170">
        <table>
          <tr>
            <td align="center">Date</td>
            <td align="center">PROGRESS  NOTES</td>
            <td align="center">User</td>
            <td></td>
          </tr>
          <tr>
            <td type="button" member="n1_date" height="30" width="100"></td>
            <td type="text" style="multi" height="60" member="n1_comment" rowspan="2" name="teComment_n1" width="600"></td>
            <td type="text" style="readonly" member="n1_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n1"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n1"></td>            
          </tr>

          <tr>
            <td type="button" member="n2_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n2_comment" rowspan="2" name="teComment_n2" width="600"></td>
            <td type="text" style="readonly" member="n2_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n2"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n2"></td>

          </tr>

        </table>
      </td>
    </tr>

    <tr>
      <td type="table" height="170">
        <table>
          <tr>
            <td type="button" member="n3_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n3_comment" rowspan="2" name="teComment_n3"  width="600"></td>
            <td type="text" style="readonly" member="n3_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n3"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n3"></td>
          </tr>

          <tr>
            <td type="button" member="n4_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n4_comment" rowspan="2" name="teComment_n4"  width="600"></td>
            <td type="text" style="readonly" member="n4_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n4"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n4"></td>

          </tr>
        </table>
      </td>
    </tr>


    <tr>
      <td type="table" height="170">
        <table>
          <tr>
            <td type="button" member="n5_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n5_comment" rowspan="2" name="teComment_n5"  width="600"></td>
            <td type="text" style="readonly" member="n5_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n5"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n5"></td>

          </tr>

          <tr>
            <td type="button" member="n6_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n6_comment" rowspan="2" name="teComment_n6"  width="600"></td>
            <td type="text" style="readonly" member="n6_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n6"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n6"></td>

          </tr>
        </table>
      </td>
    </tr>

    <tr>
      <td type="table" height="170">
        <table>
          <tr>
            <td type="button" member="n7_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n7_comment" rowspan="2" name="teComment_n7"  width="600"></td>
            <td type="text" style="readonly" member="n7_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n7"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n7"></td>
            
          </tr>

          <tr>
            <td type="button" member="n8_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n8_comment" rowspan="2" name="teComment_n8"  width="600"></td>
            <td type="text" style="readonly" member="n8_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n8"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n8"></td>
            
          </tr>
        </table>
      </td>
    </tr>

    <tr>
      <td type="table" height="100">
        <table>
          <tr>
            <td colspan="3" align="center">SUPERVISORY  VISIT  NOTATIONS</td>
          </tr>
          <tr>
            <td type="button" member="n9_date" height="30" width="100" ></td>
            <td type="text" style="multi" height="60" member="n9_comment" rowspan="2" name="teComment_n9"  width="600"></td>
            <td type="text" style="readonly" member="n9_username" width="200"></td>
          </tr>
          <tr>
            <td type="button" mask="Remove" height="25" name="btnRemove_n9"></td>
            <td type="button" height="20" width="20" mask="+!" name="btnAddComment_n9"></td>
            
          </tr>
        </table>
      </td>
    </tr>




    <tr>
      <td type="combo" name="cobComments"></td>
    </tr>
    <tr>
      <td type="table" >
        <table>
          <tr>
            <td type="text" style="readonly" name="teClientName"></td>
            <td type="button" mask="MedProfile" name="btnMedProfile"></td>
            <td type="button" mask="CCP" name="btnICD9"></td>
            <td>on</td>
            <td type="button" name="btnDate"></td>
            <td type="button" mask="MIF/CCNF List" name="btnMIFCCNFList"></td>
            <td type="button" name="btnPrint" width="26" height="26"></td>
            <td type="button" name="btnSpell" mask="Check Spell" width="100" height="26"></td>
            <td type="text" style="readonly" name="teLOC"></td>
            <td></td>
          </tr>
        </table>
      </td>

    </tr>
    <tr>
      <td ></td>
    </tr>
  </Table>
</Form>
