surname firstname name birthday sex date address city phn postal leftlabel -upper corner old hospital style multi line hphone wphone billing -your billing number cellular doctor_to_label - multi-line box pat_mailing - multi-line box allergies - multi-line box rx - multi-line box letter1 - MD name letter2 -MD address letter3 _MD city letter4 -MD postal mdfax mdphone gfr the last GFR and date prov pts province