Reminder

X009 - Reminder

SED API version: 0.16.2 build 2
Model version: 4.2.0

Case Context *

Person Context*
Employer Context*
Reimbursement Context*

Family name(s) *

{{metaSection.familyName.$$error}} {{metaSection.familyName.$$warning}}

Forename(s) *

{{metaSection.forename.$$error}} {{metaSection.forename.$$warning}}

Date of birth *

{{metaSection.dateBirth.$$error}} {{metaSection.dateBirth.$$warning}}

Sex *

{{option.name}}

{{metaSection.sex.$$error}} {{metaSection.sex.$$warning}}

Name *

{{metaSection.name.$$error}} {{metaSection.name.$$warning}}

Identification numbers

Identification number

Number *

{{metaSection.number.$$error}} {{metaSection.number.$$warning}}

Type *

{{option.name}}

{{metaSection.type.$$error}} {{metaSection.type.$$warning}}

Identification number

Address

Street

{{metaSection.street.$$error}} {{metaSection.street.$$warning}}

Building Name

{{metaSection.buildingName.$$error}} {{metaSection.buildingName.$$warning}}

Town *

{{metaSection.town.$$error}} {{metaSection.town.$$warning}}

Postal Code

{{metaSection.postalCode.$$error}} {{metaSection.postalCode.$$warning}}

Region

{{metaSection.region.$$error}} {{metaSection.region.$$warning}}

Country *

{{$select.selected[ 'name']}}

{{metaSection.country.$$error}} {{metaSection.country.$$warning}}

Reimbursement Request ID *

{{metaSection.reimbursementRequestID.$$error}} {{metaSection.reimbursementRequestID.$$warning}}

Total number of individual claims *

{{metaSection.totalNumberIndividualClaims.$$error}} {{metaSection.totalNumberIndividualClaims.$$warning}}

Reminders *

Reminder to send us *

Type *

{{option.name}}

{{metaSection.type.$$error}} {{metaSection.type.$$warning}}

Details

{{metaSection.details.$$error}} {{metaSection.details.$$warning}}

Reminder to send us

{{ row.severityMessage }} : {{ row.message }}