CÃÂºram V7 User Interface

Provider Name

Proximity To

Address

Distance [?]

Specialties

	Select Row	Provider Name	Type	Address	Specialties	Proximity
		[field-value] [field-value]	[field-value]	[Address]	[field-value]	[field-value]
</td></tr></tbody></table><jsp:scriptlet xmlns:jsp="http://java.sun.com/JSP/Page"><![CDATA[curam.util.client.jsp.JspUtil.outputListReadingScripts(pageContext,"N20CEA");]]></jsp:scriptlet><script type="text/javascript">require(["curam/util/ExpandableLists"], function() {curam.util.ExpandableLists.setMinimumExpandedHeight('ProviderManagement_specifyReferralProviderCPMService-N20CEA', 0);curam.util.ExpandableLists.loadStateData('ProviderManagement_specifyReferralProviderCPMService-N20CEA');});</script></div></div><div class="cluster cluster-with-header is-uncollapsed label-field"><div style="zoom:1;"><div class="header-wrapper"><h3 title="Specify Provider Details" class="collapse"><span class="collapse-title">Specify Provider Details</span></h3><button title="${clusterToggleArrow}" class="grouptoggleArrow" tabIndex="0" onclick="toggleCluster(this,arguments[0]);" onKeyPress="if(curam.util.enterKeyPress(event)){toggleCluster(this,arguments[0]);}" type="button" aria-label="Specify Provider DetailsToggle Button" aria-expanded="true"> <img src="../themes/curam/images/Arrow_Down_Blue80_20px.png" onLoad="setToggleClusterIcon(this);" class="defaultIcon" alt=""/><img src="../themes/curam/images/Arrow_Down_Blue50_20px.png" onLoad="setToggleClusterIcon(this);" class="hoverIcon" alt=""/><span class="hidden">Toggle Button</span></button></div><table cellspacing="0" cellpadding="0" class="input-cluster" role="presentation" summary="Specify Provider Details"><col width="10%"/><col width="40%"/><col width="10%"/><col width="40%"/><tbody><tr><th id="N20D64-1-1" class="label"><span class="label" title="Name">Name</span></th><td headers="N20D64-1-1" class="field"><input type="text" class="text"/></td><th id="N20D64-1-1-b" class="cluster-pad-first"> </th><td headers="N20D64-1-1-b" class="cluster-pad"/></tr></tbody></table><jsp:scriptlet xmlns:jsp="http://java.sun.com/JSP/Page"><![CDATA[pageContext.removeAttribute("clusterTitle");]]></jsp:scriptlet></div></div><div class="cluster cluster-with-no-header label-field"><div style="zoom:1;"><table cellspacing="0" cellpadding="0" class="input-cluster" role="presentation"><col width="10%"/><col width="40%"/><col width="10%"/><col width="40%"/><tbody><tr><td><input type="text"/></td></tr></tbody></table><jsp:scriptlet xmlns:jsp="http://java.sun.com/JSP/Page"><![CDATA[pageContext.removeAttribute("clusterTitle");]]></jsp:scriptlet></div></div><div class="cluster cluster-with-no-header label-field"><div style="zoom:1;"><table cellspacing="0" cellpadding="0" class="input-cluster" role="presentation" summary="${pageScope.defaultTableSummary}"><col width="10%"/><col width="40%"/><col width="10%"/><col width="40%"/><tbody><tr><th id="N20D92-1-1" class="label"><span class="label" title="Email">Email</span></th><td headers="N20D92-1-1" class="field"><input type="text" class="text"/></td><th id="N20D92-1-2" class="label"><span class="label" title="Phone">Phone</span></th><td headers="N20D92-1-2" class="container last-cell"><span class="container"><input type="text" class="text" style="width:3em"/><span class="separator"> </span><input type="text" class="text" style="width:3em"/><span class="separator"> </span><input type="text" class="text" style="width:8em"/></span></td></tr></tbody></table><jsp:scriptlet xmlns:jsp="http://java.sun.com/JSP/Page"><![CDATA[pageContext.removeAttribute("clusterTitle");]]></jsp:scriptlet></div></div></div></div></body></html>