| Prompt | Response | Req | Len |
|---|---|---|---|
| ADDRESS LINES B, C, D: | Type the name of the Additional Information field that will display in the Protocol Code Table. | 0 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| ADDITIONAL INFORMATION LINES: | Type the name of the Additional Information field that will display in the Protocol Code Table. | 0 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 | |
| Field Description | Type the name of the Additional Information field that will display in the Protocol Code Table. | 30 |
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