{ "document_id": 16513, "page": 93, "width_pt": 612, "height_pt": 792, "rotation": 0, "pipeline_version": "paddleocr-vl-1.6+paul-48", "engine": "paddleocr_vl", "source_run_id": 16628, "item_count": 36, "counts_by_type": { "figure": 2, "header": 4, "heading": 1, "list": 1, "list_item": 13, "table": 1, "table_cell": 5, "text": 9 }, "build_ms": 2, "items": [ { "id": "p93.1", "order": 1, "type": "figure", "bbox": { "l": 66, "t": 725.76, "r": 141.36, "b": 684.24 }, "text": "", "attrs": { "role": "page_header", "block_label": "header_image" } }, { "id": "p93.2", "order": 2, "type": "header", "bbox": { "l": 145.68, "t": 720, "r": 371.28, "b": 699.84 }, "text": "KENTUCKY STATE UNIVERSITY", "attrs": { "block_label": "header" }, "level": 2 }, { "id": "p93.3", "order": 3, "type": "header", "bbox": { "l": 156.96, "t": 691.92, "r": 230.88, "b": 681.6 }, "text": "SCHOOL OF NURSING", "attrs": { "block_label": "header" }, "level": 2 }, { "id": "p93.4", "order": 4, "type": "header", "bbox": { "l": 422.88, "t": 718.08, "r": 520.32, "b": 699.36 }, "text": "400 EAST MAIN STREET\nFRANKFORT, KENTUCKY 40601", "attrs": { "block_label": "header" }, "level": 2 }, { "id": "p93.5", "order": 5, "type": "header", "bbox": { "l": 408.96, "t": 692.16, "r": 517.92, "b": 681.6 }, "text": "BETTY WHITE HEALTH CENTER", "attrs": { "block_label": "header" }, "level": 2 }, { "id": "p93.6", "order": 6, "type": "figure", "bbox": { "l": 65.6, "t": 728, "r": 521.36, "b": 680.15 }, "text": "", "attrs": { "source": "pdf_image" } }, { "id": "p93.7", "order": 7, "type": "heading", "bbox": { "l": 68.64, "t": 659.76, "r": 430.08, "b": 646.32 }, "text": "PART B – PRECEPTOR INFORMATION (Must be completed in full)", "attrs": { "block_label": "paragraph_title" }, "level": 3 }, { "id": "p93.8", "order": 8, "type": "list", "bbox": { "l": 68.4, "t": 624.96, "r": 505.68, "b": 381.84 }, "text": "", "attrs": { "item_count": 13 }, "children": [ { "id": "p93.8.1", "order": 9, "type": "list_item", "bbox": { "l": 68.64, "t": 624.96, "r": 505.68, "b": 601.44 }, "text": "Preceptor Name: ___\n(First) (Middle) (Last)" }, { "id": "p93.8.2", "order": 10, "type": "list_item", "bbox": { "l": 69.12, "t": 589.68, "r": 497.04, "b": 576.96 }, "text": "(Position/Title): ___" }, { "id": "p93.8.3", "order": 11, "type": "list_item", "bbox": { "l": 69.84, "t": 564.24, "r": 169.2, "b": 552.24 }, "text": "Academic Preparation" }, { "id": "p93.8.4", "order": 12, "type": "list_item", "bbox": { "l": 68.4, "t": 539.76, "r": 363.84, "b": 526.56 }, "text": "Credentials (circle one): DO MD NP Other_____" }, { "id": "p93.8.5", "order": 13, "type": "list_item", "bbox": { "l": 68.64, "t": 514.32, "r": 455.04, "b": 501.12 }, "text": "License Number_____State_____Expiration Date" }, { "id": "p93.8.6", "order": 14, "type": "list_item", "bbox": { "l": 69.6, "t": 501.12, "r": 458.4, "b": 489.84 }, "text": "(If appropriate)" }, { "id": "p93.8.7", "order": 15, "type": "list_item", "bbox": { "l": 69.36, "t": 478.32, "r": 457.2, "b": 463.68 }, "text": "Certification Agency_____ Expiration Date" }, { "id": "p93.8.8", "order": 16, "type": "list_item", "bbox": { "l": 69.6, "t": 465.84, "r": 127.2, "b": 454.32 }, "text": "(If appropriate)" }, { "id": "p93.8.9", "order": 17, "type": "list_item", "bbox": { "l": 69.12, "t": 444.96, "r": 450.96, "b": 432.48 }, "text": "If the Preceptor is a Nurse Practitioner or Nurse Midwife, WRITE-IN the name of the" }, { "id": "p93.8.10", "order": 18, "type": "list_item", "bbox": { "l": 69.12, "t": 430.08, "r": 500.16, "b": 419.76 }, "text": "Collaborating Physician ___" }, { "id": "p93.8.11", "order": 19, "type": "list_item", "bbox": { "l": 69.6, "t": 419.04, "r": 499.92, "b": 406.32 }, "text": "and his/her Certification_____Expiration Date_____" }, { "id": "p93.8.12", "order": 20, "type": "list_item", "bbox": { "l": 69.6, "t": 406.8, "r": 155.28, "b": 394.56 }, "text": "Certifying Agency" }, { "id": "p93.8.13", "order": 21, "type": "list_item", "bbox": { "l": 69.36, "t": 394.8, "r": 503.04, "b": 381.84 }, "text": "Years of Experience ___" } ] }, { "id": "p93.9", "order": 22, "type": "text", "bbox": { "l": 68.16, "t": 367.68, "r": 546.48, "b": 351.84 }, "text": "Preceptor's Employing Agency" }, { "id": "p93.10", "order": 23, "type": "text", "bbox": { "l": 69.36, "t": 339.6, "r": 102, "b": 327.84 }, "text": "Name: ___" }, { "id": "p93.11", "order": 24, "type": "text", "bbox": { "l": 68.4, "t": 314.88, "r": 494.88, "b": 301.44 }, "text": "Agency Address:___" }, { "id": "p93.12", "order": 25, "type": "text", "bbox": { "l": 69.84, "t": 287.04, "r": 490.56, "b": 275.28 }, "text": "
\"Image\"
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\"Image\"
" }, { "id": "p93.18", "order": 31, "type": "table", "bbox": { "l": 66.24, "t": 170.16, "r": 540.96, "b": 78.72 }, "text": "", "attrs": { "block_label": "table", "n_rows": 3, "n_cols": 2, "integrity": { "cells_checked": 5, "cells_flagged": 0 } }, "children": [ { "id": "p93.18.1", "order": 32, "type": "table_cell", "bbox": { "l": 71.304, "t": 164.16031999999996, "r": 209.99576, "b": 154.22432000000003 }, "text": "I agree to serve as preceptor for", "attrs": { "row": 0, "col": 0, "rowspan": 1, "colspan": 1, "bbox_refit": true } }, { "id": "p93.18.2", "order": 33, "type": "table_cell", "bbox": { "l": 323.69, "t": 151.68032000000005, "r": 364.08536, "b": 141.74432000000002 }, "text": "(Student)", "attrs": { "row": 0, "col": 1, "rowspan": 1, "colspan": 1, "bbox_refit": true } }, { "id": "p93.18.3", "order": 34, "type": "table_cell", "bbox": { "l": 179.18, "t": 121.44032000000004, "r": 361.09768, "b": 111.50432 }, "text": "Dates for implementing Scholarly Project", "attrs": { "row": 1, "col": 0, "rowspan": 1, "colspan": 2, "bbox_refit": true } }, { "id": "p93.18.4", "order": 35, "type": "table_cell", "bbox": { "l": 71.184, "t": 93.38063999999997, "r": 215.59712, "b": 81.14832000000001 }, "text": "PRECEPTOR'S SIGNATURE", "attrs": { "row": 2, "col": 0, "rowspan": 1, "colspan": 1, "bbox_refit": true } }, { "id": "p93.18.5", "order": 36, "type": "table_cell", "bbox": { "l": 503.5, "t": 91.08432000000005, "r": 533.42944, "b": 81.14832000000001 }, "text": "DATE", "attrs": { "row": 2, "col": 1, "rowspan": 1, "colspan": 1, "bbox_refit": true } } ] } ], "excluded_furniture": { "first": [], "last": [] } }