       01  PATIENT-PERSONAL-MASTER-REC.                                         
           05  PATIENT-NBR-MR          PIC X(6).                                
           05  SSNBR                   PIC X(10).                               
           05  AGE                     PIC 9(03).                               
           05  DRIVERS-LICENSE-NO      PIC X(10).                               
           05  ISSUING-STATE           PIC X(02).                               
           05  OCCUPATION              PIC X(20).                               
           05  EMPLOYER.                                                        
               10  EMP-NAME   PIC X(30).                                        
               10  EMP-ADDR   PIC X(30).                                        
               10  EMP-CITY   PIC X(30).                                        
               10  EMP-STATE  PIC X(02).                                        
               10  EMP-ZIP    PIC X(09).                                        
           05  MARITAL-STATUS PIC X(01).                                        
               88 MARRIED      VALUE "M".                                       
               88 SINGLE       VALUE "S".                                       
               88 DIVORCED     VALUE "D".                                       
               88 WIDOWED      VALUE "W".                                       
               88 VALID-STATUS                                                  
                   VALUES ARE "M", "S", "W", "D".                               
           05  PATIENT-NAME.                                                    
               10 LAST-NAME   PIC X(15).                                        
               10 MIDINIT     PIC X(01).                                        
               10 FIRST-NAME  PIC X(20).                                        
           05  PHONE-HOME     PIC X(10).                                        
           05  PHONE-WORK    PIC X(10).                                         
           05  PHONE-MOBILE  PIC X(10).                                         
           05  HEIGHT        PIC 9(02).                                         
           05  WEIGHT        PIC 9(03).                                         
           05  GENDER        PIC X(01).                                         
               88  FEMALE          VALUE "F".                                   
               88  MALE            VALUE "M".                                   
               88  NOT-PROVIDED    VALUE "N".                                   
               88 VALID-GENDER                                                  
                   VALUES ARE "F", "M", "N".                                    
           05  DOB                     PIC 9(05).                               
           05  FAMILY-CONTACT-PRIMARY  PIC X(30).                               
           05  FCON-RELATIONSHIP       PIC X(02).                               
               88  SPOUSE      VALUE "SP".                                      
               88  SIBLING     VALUE "SI".                                      
               88  CHILD       VALUE "CH".                                      
               88  FRIEND      VALUE "FR".                                      
               88 VALID-RELS                                                    
                   VALUES ARE "SP", "SI", "CH", "FR".                           
           05  MINOR-INDICATOR         PIC X(01) VALUE SPACES.                  
           05  RESPONSIBLE-PARTY.                                               
               10  SSN           PIC X(10).                                     
               10  OCCUPATION    PIC X(30).                                     
               10  EMPLOYER      PIC X(30).                                     
               10  CITY          PIC X(20).                                     
               10  ST            PIC X(02).                                     
               10  ZIP           PIC X(09).                                     
           05  FCON-PHONE-H      PIC 9(10).                                     
           05  FCON-PHONE-C        PIC X(10) VALUE SPACE.                       
           05  PAYMENT-METHOD-TYPE     PIC X(02).                               
               88 CREDIT-CARD      VALUE "CC".                                  
               88 CHECK            VALUE "CH".                                  
               88 CASH             VALUE "CA".                                  
               88 VALID-PAYMENT-METHOD                                          
                   VALUES ARE "CC", "CH", "CA".                                 
           05  CREDIT-CARD-EXP-DATE.                                            
               10  EXP-MONTH           PIC 9(02).                               
               10  EXP-YEAR            PIC 9(04).                               
           05  HOME-ADDRESS.                                                    
               10 APARTMENT-NBR PIC X(05).                                      
               10 STREET        PIC X(30).                                      
               10 CITY          PIC X(20).                                      
               10 STATE         PIC X(02).                                      
               10 POSTAL-CODE   PIC X(09).                                      
               10 COUNTRY              PIC X(20).                               
           05  OCCUPATION              PIC X(30).                               
           05  EMPLOYER                PIC X(30).                               
           05  PATIENT-COMMENTS        PIC X(255).                              
