{
  "document_metadata": {
    "page_number": "1185",
    "document_number": "DOJ-OGR-00025390",
    "date": null,
    "document_type": "Medical Form",
    "has_handwriting": true,
    "has_stamps": false
  },
  "full_text": "Page 1185\n\nDiscussion with patient or patient's family regarding prognosis ___Yes ___No NA\nDNR order ___Yes ___No Date\nAdvance Directive / Living Will ___Yes ___No NA\n\nLOCAL COMMUNITY HOSPITALIZATIONS ONLY:\nType of admission ___Routine Emergent ___Other\nMethod of transportation appropriate to patient condition Yes ___No ___NA\nSeverity of condition at time of admission to local hospital ___Critical ___Stable ___Unknown\nPrognosis on admission to local hospital ___Poor ___Good ___Unknown\nWere diagnostic procedures appropriate and timely Yes ___No\nWas treatment appropriate to diagnosis and instituted timely Yes ___No\nPrognosis with treatment ___Poor ___Good ___Unknown\nAny complications adversely affecting outcome: (describe briefly) Asphyxiation Secondary to Hanging. Yes ___No\nWas treatment appropriate to complication Yes ___No\nSurgical Procedures (list) ___Yes No\n\nAppropriate pre-operative evaluation completed, including lab, physical exam, updated history ___Yes No\nComplications related to surgical procedures Describe ___Yes No\n\nPrognosis following surgical procedure ___Poor ___Good Unknown\nPatient compliant with treatment / medications ___Yes ___No NA\nDiscussion with patient or patient's family regarding patient prognosis ___Yes ___No NA\n\nPDF Prescribed by P6013 4\nDOJ-OGR-00025390",
  "text_blocks": [
    {
      "type": "printed",
      "content": "Discussion with patient or patient's family regarding prognosis",
      "position": "top"
    },
    {
      "type": "handwritten",
      "content": "NA",
      "position": "top"
    },
    {
      "type": "printed",
      "content": "DNR order",
      "position": "top"
    },
    {
      "type": "handwritten",
      "content": "No",
      "position": "top"
    },
    {
      "type": "printed",
      "content": "Advance Directive / Living Will",
      "position": "top"
    },
    {
      "type": "handwritten",
      "content": "NA",
      "position": "top"
    },
    {
      "type": "printed",
      "content": "LOCAL COMMUNITY HOSPITALIZATIONS ONLY:",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Emergent",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Yes",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Critical",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Poor",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Yes",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Yes",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Poor",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Asphyxiation Secondary to Hanging.",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Yes",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Yes",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "No",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "No",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "No",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "Unknown",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "NA",
      "position": "middle"
    },
    {
      "type": "handwritten",
      "content": "NA",
      "position": "middle"
    }
  ],
  "entities": {
    "people": [],
    "organizations": [],
    "locations": [],
    "dates": [],
    "reference_numbers": [
      "P6013",
      "DOJ-OGR-00025390"
    ]
  },
  "additional_notes": "The document appears to be a medical form related to a patient's hospitalization and treatment. The form contains various sections with checkboxes and handwritten notes. The patient's condition is described as critical, with a poor prognosis. The cause of the condition is listed as asphyxiation secondary to hanging."
}