| Name | Description | Type | Additional information |
|---|---|---|---|
| form_num | integer |
None. |
|
| cust_num | integer |
None. |
|
| visit_code | integer |
None. |
|
| debit_line_code | integer |
None. |
|
| emp_sig_first | integer |
None. |
|
| content | string |
None. |
|
| css | string |
None. |
|
| footerText | string |
None. |
|
| fix_answer | boolean |
None. |