{ "document_id": 11418, "page": 4, "width_pt": 595.276, "height_pt": 841.89, "rotation": 0, "pipeline_version": "paddleocr-vl-1.6+paul-48", "engine": "paddleocr_vl", "source_run_id": 11529, "item_count": 26, "counts_by_type": { "figure": 3, "footer": 1, "form_field": 2, "header": 1, "heading": 4, "text": 15 }, "build_ms": 2, "items": [ { "id": "p4.1", "order": 1, "type": "figure", "bbox": { "l": 45.8274, "t": 799.8915, "r": 157.1567, "b": 776.8523 }, "text": "", "attrs": { "role": "page_header", "block_label": "header_image", "embedded_text": "Section C:" } }, { "id": "p4.2", "order": 2, "type": "header", "bbox": { "l": 184.0293, "t": 809.7311, "r": 519.4569, "b": 762.6928 }, "text": "Evidence of Disability Form 2027\nSections 1-8", "attrs": { "block_label": "header" }, "level": 2 }, { "id": "p4.3", "order": 3, "type": "heading", "bbox": { "l": 39.829, "t": 724.5342, "r": 517.7774, "b": 705.5749 }, "text": "Please complete all sections below in TYPE or BLOCK capitals:", "attrs": { "block_label": "paragraph_title" }, "level": 3 }, { "id": "p4.4", "order": 4, "type": "heading", "bbox": { "l": 41.5086, "t": 665.7363, "r": 181.1501, "b": 647.9769 }, "text": "1. Applicant details", "attrs": { "block_label": "paragraph_title" }, "level": 3 }, { "id": "p4.5", "order": 5, "type": "text", "bbox": { "l": 59.9835, "t": 637.8973, "r": 197.7055, "b": 623.7378 }, "text": "Title and Full Name of Applicant" }, { "id": "p4.6", "order": 6, "type": "text", "bbox": { "l": 60.2234, "t": 605.9784, "r": 116.8478, "b": 592.0589 }, "text": "Date of Birth" }, { "id": "p4.7", "order": 7, "type": "text", "bbox": { "l": 60.7033, "t": 574.2995, "r": 118.5273, "b": 560.38 }, "text": "CAO Number" }, { "id": "p4.8", "order": 8, "type": "figure", "bbox": { "l": 203.7039, "t": 615.5781, "r": 448.4365, "b": 552.4603 }, "text": "", "attrs": { "block_label": "image" }, "children": [ { "id": "p4.8.1", "order": 9, "type": "text", "bbox": { "l": 203.9438, "t": 615.5781, "r": 448.6764, "b": 584.1392 }, "text": "□ □ / □ / □ □ □ □ □", "children": [ { "id": "p4.8.1.1", "order": 10, "type": "form_field", "bbox": { "l": 229.71, "t": 615.58, "r": 241.71, "b": 603.58 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "/", "source": "glyph_estimate", "bbox_estimated": true, "text_offset": 2, "text_span": 1 } }, { "id": "p4.8.1.2", "order": 11, "type": "form_field", "bbox": { "l": 281.23, "t": 615.58, "r": 293.23, "b": 603.58 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "/", "source": "glyph_estimate", "bbox_estimated": true, "text_offset": 6, "text_span": 1 } } ] } ] }, { "id": "p4.9", "order": 12, "type": "heading", "bbox": { "l": 39.829, "t": 511.4218, "r": 449.1563, "b": 477.103 }, "text": "2. Medical Consultant/Specialist who made the diagnosis (GPs should not enter their own details here, see further instructions below)", "attrs": { "block_label": "paragraph_title" }, "level": 3 }, { "id": "p4.10", "order": 13, "type": "text", "bbox": { "l": 60.4633, "t": 465.3434, "r": 225.058, "b": 451.4239 }, "text": "Name and Title of Consultant/Specialist" }, { "id": "p4.11", "order": 14, "type": "text", "bbox": { "l": 60.4633, "t": 433.6645, "r": 199.8649, "b": 419.745 }, "text": "Position/Professional Credentials" }, { "id": "p4.12", "order": 15, "type": "text", "bbox": { "l": 60.4633, "t": 401.9857, "r": 123.0861, "b": 388.0662 }, "text": "Date of Report" }, { "id": "p4.13", "order": 16, "type": "text", "bbox": { "l": 60.4633, "t": 370.3068, "r": 166.7541, "b": 356.1473 }, "text": "Date of onset of disability" }, { "id": "p4.14", "order": 17, "type": "text", "bbox": { "l": 60.4633, "t": 338.6279, "r": 191.7072, "b": 324.2284 }, "text": "Date of diagnosis by consultant" }, { "id": "p4.15", "order": 18, "type": "text", "bbox": { "l": 60.7033, "t": 310.7889, "r": 162.1953, "b": 284.8698 }, "text": "Date of Referral from GP to Consultant/Specialist" }, { "id": "p4.16", "order": 19, "type": "figure", "bbox": { "l": 228.4171, "t": 472.3032, "r": 478.6681, "b": 284.6299 }, "text": "", "attrs": { "block_label": "image", "embedded_text": "/ /\n/ /\n/ /\n/ /" } }, { "id": "p4.17", "order": 20, "type": "heading", "bbox": { "l": 47.267, "t": 243.5913, "r": 499.7823, "b": 227.0319 }, "text": "Note for GPs: If form is completed by a GP, GP must tick the following box", "attrs": { "block_label": "paragraph_title" }, "level": 3 }, { "id": "p4.18", "order": 21, "type": "text", "bbox": { "l": 47.027, "t": 221.9921, "r": 436.6797, "b": 195.833 }, "text": "I have sufficient information on file from the appropriate consultant/specialist named above, diagnosing the applicant with one or more of the conditions indicated in Section 3." }, { "id": "p4.19", "order": 22, "type": "text", "bbox": { "l": 47.267, "t": 193.4331, "r": 462.3526, "b": 154.0745 }, "text": "I have provided the applicant with a copy of a document in which their diagnosis is confirmed by the appropriate consultant/specialist and is within the specified time limit (if one applies) for submission with this form." }, { "id": "p4.20", "order": 23, "type": "text", "bbox": { "l": 47.5069, "t": 151.4346, "r": 350.7834, "b": 137.7551 }, "text": "If the information is on file, please complete sections 2-8 as appropriate." }, { "id": "p4.21", "order": 24, "type": "text", "bbox": { "l": 513.4585, "t": 218.1522, "r": 543.2103, "b": 187.4333 }, "text": "
\"Image\"
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