www.bmc-iCode.com
Device Information
* Device Serial Number
CTX/CSX
* iCode Collection Date
(YYYY-MM-DD)
Unit
        
iCode Information
iCode-1
* iCode-7
* iCode-30
* iCode-60
(USA Only)
* iCode-90
* iCode-182
* iCode-365
iCode 60 function is currently available in U.S. location. To see your iCode specification, please turn to your local distributors.
Patient Information
Patient ID
Patient Name
Address
Phone
Notes
Gender
Date of Birth
(YYYY-MM-DD)
Therapy from
(YYYY-MM-DD)


Provider Information
Organization
Street 1
Street 2
City
Phone
Physician Information
Name
Organization
Street 1
Street 2
City
Phone
Email
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