1.0 Generic Claim Form (GCLAIMHPHO) +
GCLAIM.HPHO N HPHO Generic Claim Form PW 1 0 0 1 N C:\\HLINK\\FF_OUT\\COMPHEAL N JScript 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 M001007 20071102142027 NA NA M 20130610203601 SFE PROCON2 M 0 0 0 GCLAIM.HPHO 1 2 H Generic Claim FormS N 0 0 1 0 0 0 0 0 N GCLAIM.HPHO 2 3 N \r\nVersion 1.0.0 N 0 0 0 0 0 0 0 0 N GCLAIM.HPHO 4 1 H N 0 0 0 0 0 0 0 0 N GCLAIM.HPHO 5 4 F CONSENT.HPHO Patient Consent N 0 0 0 0 0 0 0 0 N 1 GCLAIM.HPHO 6 5 F STATE.HPHO State (Internal use) N 0 0 0 0 0 0 0 0 N 2 GCLAIM.HPHO 7 6 F STATEX.HPHO State extra (Internal use) N 0 0 0 0 0 0 0 0 N 3 GCLAIM.HPHO 8 7 N .\r\n.\r\n.\r\n.\r\n.\r\n.\r\n.\r\n. N 0 0 0 0 0 0 0 0 D GCLAIM.HPHO 5 CONSENT.HPHO Yes 1 GCLAIM.HPHO DOB 0 0 Patient must have a Date of Birth Recorded GCLAIM.HPHO ENRC 0 0 Patient must have Enrolment Confirmed GCLAIM.HPHO ETHNIC 0 0 Patient must have a Ethnicity Recorded GCLAIM.HPHO NHINO 0 0 Patient must have a NHI Number Recorded GCLAIM.HPHO REG 0 0 Patient must be a Registered Patient DOB Date of Birth Recorded 16 select 1 from patient where patientid = "%PATIENTID%" and DOB IS NOT NULL Patient %must% %not% have a %descr% ENRC Enrolment Confirmed 15 select 1 from patient where patientid = "%PATIENTID%" and enrolmentcode = "C" Patient %must% %not% have %descr% ETHNIC Ethnicity Recorded 14 select 1 from patient where patientid = "%PATIENTID%" and ethcode is not null and ethcode <> "" Patient %must% %not% have a %descr% NHINO NHI Number Recorded 13 select 1 from patient where patientid = "%PATIENTID%" and nhino is not null and nhino <> "" Patient %must% %not% have a %descr% REG Registered Patient 1 select 1 from patient where patientid = "%PATIENTID%" and regcode = "R" Patient %must% %not% be a %descr% GCLAIM.HPHO Location Location of HTML and Code Waitemata PHO 1 GCLAIM.HPHO Location Local GCLAIM.HPHO Location Procon GCLAIM.HPHO Location Waitemata PHO HPHO Harbour/Waitemata PHO 0 20070820153159 NA NA M 20110601105319 NA NA M 0 CONSENT.HPHO HPHO Consent to share data Patient has consented to share data * 20071107114152 NA NA M 20071107114205 NA NA M 0 STATE.HPHO HPHO Hidden field to store state * 20071107114241 NA NA M 20081007121843 NA NA M 0 STATEX.HPHO HPHO Hidden field to store eXtra state * 20081007121834 NA NA M 20081007122145 NA NA M 0 CONSENT.HPHO B 8 1 STATE.HPHO T 8 1 STATEX.HPHO T 8 1 CONSENT.HPHO Yes 1