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Text File  |  1995-05-07  |  19KB  |  577 lines
  1. VERSION 2.00
  2. Begin Form Form3 
  3.    BackColor       =   &H00C0C0C0&
  4.    BorderStyle     =   3  'Fixed Double
  5.    Caption         =   "Medical Information"
  6.    ClientHeight    =   5880
  7.    ClientLeft      =   150
  8.    ClientTop       =   1290
  9.    ClientWidth     =   9255
  10.    ControlBox      =   0   'False
  11.    Height          =   6285
  12.    Left            =   90
  13.    LinkMode        =   1  'Source
  14.    LinkTopic       =   "Form3"
  15.    MaxButton       =   0   'False
  16.    MinButton       =   0   'False
  17.    ScaleHeight     =   5880
  18.    ScaleWidth      =   9255
  19.    Top             =   945
  20.    Width           =   9375
  21.    Begin PictureBox Panel3D1 
  22.       BackColor       =   &H00C0C0C0&
  23.       ForeColor       =   &H00000000&
  24.       Height          =   1155
  25.       Left            =   2370
  26.       ScaleHeight     =   1125
  27.       ScaleWidth      =   4305
  28.       TabIndex        =   35
  29.       Top             =   5715
  30.       Width           =   4335
  31.       Begin PictureBox Command3D3 
  32.          ForeColor       =   &H00000000&
  33.          Height          =   855
  34.          Left            =   1275
  35.          Picture         =   FORM3.FRX:0000
  36.          ScaleHeight     =   825
  37.          ScaleWidth      =   1845
  38.          TabIndex        =   36
  39.          Top             =   150
  40.          Width           =   1875
  41.       End
  42.    End
  43.    Begin PictureBox Frame3D5 
  44.       ForeColor       =   &H00000000&
  45.       Height          =   1335
  46.       Left            =   120
  47.       ScaleHeight     =   1305
  48.       ScaleWidth      =   9030
  49.       TabIndex        =   23
  50.       Top             =   4290
  51.       Width           =   9060
  52.       Begin PictureBox Picture6 
  53.          BackColor       =   &H00C0C0C0&
  54.          BorderStyle     =   0  'None
  55.          Height          =   180
  56.          Left            =   7560
  57.          ScaleHeight     =   180
  58.          ScaleWidth      =   1215
  59.          TabIndex        =   43
  60.          Top             =   1035
  61.          Width           =   1215
  62.          Begin PictureBox Option3D8 
  63.             ForeColor       =   &H00000000&
  64.             Height          =   195
  65.             Left            =   675
  66.             ScaleHeight     =   165
  67.             ScaleWidth      =   540
  68.             TabIndex        =   45
  69.             Top             =   0
  70.             Width           =   570
  71.          End
  72.          Begin PictureBox Option3D7 
  73.             ForeColor       =   &H00000000&
  74.             Height          =   195
  75.             Left            =   0
  76.             ScaleHeight     =   165
  77.             ScaleWidth      =   600
  78.             TabIndex        =   44
  79.             Top             =   0
  80.             Width           =   630
  81.          End
  82.       End
  83.       Begin PictureBox Picture7 
  84.          BackColor       =   &H00C0C0C0&
  85.          BorderStyle     =   0  'None
  86.          Height          =   180
  87.          Left            =   7560
  88.          ScaleHeight     =   180
  89.          ScaleWidth      =   1215
  90.          TabIndex        =   46
  91.          Top             =   810
  92.          Width           =   1215
  93.          Begin PictureBox Option3D10 
  94.             ForeColor       =   &H00000000&
  95.             Height          =   195
  96.             Left            =   675
  97.             ScaleHeight     =   165
  98.             ScaleWidth      =   540
  99.             TabIndex        =   48
  100.             Top             =   0
  101.             Width           =   570
  102.          End
  103.          Begin PictureBox Option3D9 
  104.             ForeColor       =   &H00000000&
  105.             Height          =   195
  106.             Left            =   0
  107.             ScaleHeight     =   165
  108.             ScaleWidth      =   600
  109.             TabIndex        =   47
  110.             Top             =   0
  111.             Width           =   630
  112.          End
  113.       End
  114.       Begin PictureBox Picture4 
  115.          BackColor       =   &H00C0C0C0&
  116.          BorderStyle     =   0  'None
  117.          Height          =   180
  118.          Left            =   7560
  119.          ScaleHeight     =   180
  120.          ScaleWidth      =   1215
  121.          TabIndex        =   40
  122.          Top             =   570
  123.          Width           =   1215
  124.          Begin PictureBox Option3D3 
  125.             ForeColor       =   &H00000000&
  126.             Height          =   195
  127.             Left            =   675
  128.             ScaleHeight     =   165
  129.             ScaleWidth      =   540
  130.             TabIndex        =   42
  131.             Top             =   0
  132.             Width           =   570
  133.          End
  134.          Begin PictureBox Option3D1 
  135.             ForeColor       =   &H00000000&
  136.             Height          =   195
  137.             Left            =   0
  138.             ScaleHeight     =   165
  139.             ScaleWidth      =   585
  140.             TabIndex        =   41
  141.             Top             =   0
  142.             Width           =   615
  143.          End
  144.       End
  145.       Begin PictureBox Picture3 
  146.          BackColor       =   &H00C0C0C0&
  147.          BorderStyle     =   0  'None
  148.          Height          =   180
  149.          Left            =   7560
  150.          ScaleHeight     =   180
  151.          ScaleWidth      =   1215
  152.          TabIndex        =   37
  153.          Top             =   330
  154.          Width           =   1215
  155.          Begin PictureBox Option3D2 
  156.             ForeColor       =   &H00000000&
  157.             Height          =   195
  158.             Left            =   675
  159.             ScaleHeight     =   165
  160.             ScaleWidth      =   540
  161.             TabIndex        =   39
  162.             Top             =   0
  163.             Width           =   570
  164.          End
  165.          Begin PictureBox Option3D4 
  166.             ForeColor       =   &H00000000&
  167.             Height          =   195
  168.             Left            =   0
  169.             ScaleHeight     =   165
  170.             ScaleWidth      =   600
  171.             TabIndex        =   38
  172.             Top             =   0
  173.             Width           =   630
  174.          End
  175.       End
  176.       Begin Label Label5 
  177.          BackColor       =   &H00C0C0C0&
  178.          Caption         =   "Are you currently being treated for or taking medication for any condition or disease?"
  179.          FontBold        =   -1  'True
  180.          FontItalic      =   0   'False
  181.          FontName        =   "Arial"
  182.          FontSize        =   8.25
  183.          FontStrikethru  =   0   'False
  184.          FontUnderline   =   0   'False
  185.          Height          =   195
  186.          Left            =   150
  187.          TabIndex        =   27
  188.          Top             =   1005
  189.          Width           =   7125
  190.       End
  191.       Begin Label Label3 
  192.          BackColor       =   &H00C0C0C0&
  193.          Caption         =   "Had treatment or counseling for alcohol or drug dependency?"
  194.          FontBold        =   -1  'True
  195.          FontItalic      =   0   'False
  196.          FontName        =   "Arial"
  197.          FontSize        =   8.25
  198.          FontStrikethru  =   0   'False
  199.          FontUnderline   =   0   'False
  200.          Height          =   195
  201.          Left            =   150
  202.          TabIndex        =   25
  203.          Top             =   780
  204.          Width           =   5175
  205.       End
  206.       Begin Label Label4 
  207.          BackColor       =   &H00C0C0C0&
  208.          Caption         =   "Been a patient in a hospital, sanitarium or other institution?"
  209.          FontBold        =   -1  'True
  210.          FontItalic      =   0   'False
  211.          FontName        =   "Arial"
  212.          FontSize        =   8.25
  213.          FontStrikethru  =   0   'False
  214.          FontUnderline   =   0   'False
  215.          Height          =   195
  216.          Left            =   150
  217.          TabIndex        =   26
  218.          Top             =   555
  219.          Width           =   4950
  220.       End
  221.       Begin Label Label2 
  222.          BackColor       =   &H00C0C0C0&
  223.          Caption         =   "Had surgery or been advised to have surgery which was not done?"
  224.          FontBold        =   -1  'True
  225.          FontItalic      =   0   'False
  226.          FontName        =   "Arial"
  227.          FontSize        =   8.25
  228.          FontStrikethru  =   0   'False
  229.          FontUnderline   =   0   'False
  230.          Height          =   195
  231.          Left            =   150
  232.          TabIndex        =   24
  233.          Top