Submit a New Case
{"elements":[{"isDiscrete":false,"hidden":false,"name":"1214320748674_0.46186992609080824_0.3192946164260544","readOnly":false,"id":8102006,"type":"commentElement"},{"isDiscrete":false,"hidden":false,"name":"Patient Id","readOnly":false,"id":4458283,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Age","readOnly":false,"id":4458284,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Date of Injury","readOnly":false,"id":4458305,"type":"dateTimeElement"},{"isDiscrete":false,"hidden":false,"name":"circumstances","readOnly":false,"id":4458346,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Profession","readOnly":false,"id":4458348,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Notes","readOnly":false,"id":4458349,"type":"textBoxElement"},{"isDiscrete":false,"hidden":false,"name":"1191402829071_0.21824608254468558_0.6934448427274208","readOnly":false,"id":4458369,"type":"commentElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"true","value":"0-true"},{"text":"true","value":"1-true"},{"text":"CUP","value":"2-cup"},{"text":"false","value":"3-false"},{"text":"false","value":"4-false"}],"name":"Images","readOnly":false,"id":4458393,"type":"attachment"}]}