CÃÂºram V7 User Interface

Title	[Mr.]	Middle Name	[Other Forename]
First Name	[First Forename]	Suffix	[Esquire]
Last Name	[Surname]	Initials	[P.I.]

Marital Status	[Single]	Nationality	[American]
Birth Last Name	[Person Birth Name]	Mothers Birth Last Name	[Surname]
Gender	[Male]	Special Interest	[Medium Risk]
Date of Birth	[Date]	Date of Birth Verified	[True]
Date of Death	[Date]	Date of Death Verified	[True]
Place of Birth	[Value]	Country/Region of Birth	[United States]
Race	[field-value]	Ethnic Origin	[Hispanic or Latino]
Indigenous Person	[True]	Indigenous Group	[field-value]
Residency Abroad	[True]
Payment Frequency	[Value]	Currency	[US Dollar]
Next Payment Date	[Date]	Method Of Payment	[Cash]