{
    "document_id": 16513,
    "page": 94,
    "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": 44,
    "counts_by_type": {
        "figure": 2,
        "form_field": 4,
        "header": 4,
        "heading": 5,
        "list": 2,
        "list_item": 6,
        "text": 20,
        "title": 1
    },
    "build_ms": 4,
    "items": [
        {
            "id": "p94.1",
            "order": 1,
            "type": "figure",
            "bbox": {
                "l": 66,
                "t": 729.12,
                "r": 141.36,
                "b": 688.08
            },
            "text": "",
            "attrs": {
                "role": "page_header",
                "block_label": "header_image"
            }
        },
        {
            "id": "p94.2",
            "order": 2,
            "type": "header",
            "bbox": {
                "l": 145.44,
                "t": 724.08,
                "r": 372,
                "b": 703.44
            },
            "text": "KENTUCKY STATE UNIVERSITY",
            "attrs": {
                "block_label": "header"
            },
            "level": 2
        },
        {
            "id": "p94.3",
            "order": 3,
            "type": "header",
            "bbox": {
                "l": 157.44,
                "t": 696.24,
                "r": 231.36,
                "b": 685.44
            },
            "text": "SCHOOL OF NURSING",
            "attrs": {
                "block_label": "header"
            },
            "level": 2
        },
        {
            "id": "p94.4",
            "order": 4,
            "type": "header",
            "bbox": {
                "l": 423.6,
                "t": 721.92,
                "r": 521.04,
                "b": 703.44
            },
            "text": "400 EAST MAIN STREET\nFRANKFORT, KENTUCKY 40601",
            "attrs": {
                "block_label": "header"
            },
            "level": 2
        },
        {
            "id": "p94.5",
            "order": 5,
            "type": "header",
            "bbox": {
                "l": 409.68,
                "t": 696.48,
                "r": 519.12,
                "b": 685.68
            },
            "text": "BETTY WHITE HEALTH CENTER",
            "attrs": {
                "block_label": "header"
            },
            "level": 2
        },
        {
            "id": "p94.6",
            "order": 6,
            "type": "figure",
            "bbox": {
                "l": 65.6,
                "t": 732,
                "r": 522.22,
                "b": 684.15
            },
            "text": "",
            "attrs": {
                "source": "pdf_image"
            }
        },
        {
            "id": "p94.7",
            "order": 7,
            "type": "title",
            "bbox": {
                "l": 66.96,
                "t": 656.64,
                "r": 406.8,
                "b": 642.96
            },
            "text": "PART C – AGENCY INFORMATION (Must be completed in full)",
            "attrs": {
                "block_label": "doc_title"
            },
            "level": 2
        },
        {
            "id": "p94.8",
            "order": 8,
            "type": "heading",
            "bbox": {
                "l": 71.04,
                "t": 598.32,
                "r": 282.24,
                "b": 586.08
            },
            "text": "AGENCY for SCHOLARLY PROJECT",
            "attrs": {
                "block_label": "paragraph_title"
            },
            "level": 3
        },
        {
            "id": "p94.9",
            "order": 9,
            "type": "text",
            "bbox": {
                "l": 70.8,
                "t": 584.64,
                "r": 539.04,
                "b": 558
            },
            "text": "The Agency where the Scholarly Project will be implemented may be different from the preceptor's employing agency."
        },
        {
            "id": "p94.10",
            "order": 10,
            "type": "text",
            "bbox": {
                "l": 70.32,
                "t": 542.88,
                "r": 516.48,
                "b": 529.92
            },
            "text": "Student Name ___"
        },
        {
            "id": "p94.11",
            "order": 11,
            "type": "text",
            "bbox": {
                "l": 142.56,
                "t": 508.56,
                "r": 546,
                "b": 500.4
            },
            "text": "[p94.12.1]",
            "children": [
                {
                    "id": "p94.11.1",
                    "order": 12,
                    "type": "text",
                    "bbox": {
                        "l": 142.56,
                        "t": 508.56,
                        "r": 546,
                        "b": 500.4
                    },
                    "text": "1/2",
                    "attrs": {
                        "inline": true,
                        "text_offset": 0,
                        "text_span": 10,
                        "bbox_estimated": true
                    }
                }
            ]
        },
        {
            "id": "p94.12",
            "order": 13,
            "type": "heading",
            "bbox": {
                "l": 70.56,
                "t": 499.92,
                "r": 168,
                "b": 486.96
            },
            "text": "Agency Information",
            "attrs": {
                "block_label": "paragraph_title"
            },
            "level": 3
        },
        {
            "id": "p94.13",
            "order": 14,
            "type": "text",
            "bbox": {
                "l": 68.64,
                "t": 499.44,
                "r": 547.68,
                "b": 485.28
            },
            "text": "formation"
        },
        {
            "id": "p94.14",
            "order": 15,
            "type": "text",
            "bbox": {
                "l": 70.32,
                "t": 459.84,
                "r": 516.24,
                "b": 447.12
            },
            "text": "The Name of the agency, clinic, group, or entity where Scholarly Project implementation will occur:"
        },
        {
            "id": "p94.15",
            "order": 16,
            "type": "heading",
            "bbox": {
                "l": 70.8,
                "t": 434.4,
                "r": 188.4,
                "b": 421.44
            },
            "text": "Contact person at agency:",
            "level": 3
        },
        {
            "id": "p94.16",
            "order": 17,
            "type": "list",
            "bbox": {
                "l": 72.864,
                "t": 408.05032,
                "r": 295.00448,
                "b": 372.91432
            },
            "text": "",
            "attrs": {
                "item_count": 2
            },
            "children": [
                {
                    "id": "p94.16.1",
                    "order": 18,
                    "type": "list_item",
                    "bbox": {
                        "l": 72.864,
                        "t": 408.05032,
                        "r": 227.62328,
                        "b": 398.11432
                    },
                    "text": "Telephone Number with area code: ___"
                },
                {
                    "id": "p94.16.2",
                    "order": 19,
                    "type": "list_item",
                    "bbox": {
                        "l": 72.864,
                        "t": 382.85032,
                        "r": 295.00448,
                        "b": 372.91432
                    },
                    "text": "Mailing address of Office Manager/Administrator: ___"
                }
            ]
        },
        {
            "id": "p94.17",
            "order": 20,
            "type": "text",
            "bbox": {
                "l": 323.28,
                "t": 371.76,
                "r": 476.4,
                "b": 361.68
            },
            "text": "(if different from agency mailing address)"
        },
        {
            "id": "p94.18",
            "order": 21,
            "type": "text",
            "bbox": {
                "l": 71.52,
                "t": 359.76,
                "r": 515.52,
                "b": 347.52
            },
            "text": "<div style=\"text-align: center;\"><img src=\"imgs/img_in_image_box_0_0_1882_30.jpg\" alt=\"Image\" width=\"100%\" /></div>\n\n\n<div style=\"text-align: center;\"><img src=\"imgs/img_in_image_box_13_66_868_83.jpg\" alt=\"Image\" width=\"45%\" /></div>"
        },
        {
            "id": "p94.19",
            "order": 22,
            "type": "text",
            "bbox": {
                "l": 314.16,
                "t": 354.72,
                "r": 512.4,
                "b": 345.6
            },
            "text": "Country"
        },
        {
            "id": "p94.20",
            "order": 23,
            "type": "text",
            "bbox": {
                "l": 71.04,
                "t": 349.68,
                "r": 515.04,
                "b": 336.96
            },
            "text": "City State Zip Code County"
        },
        {
            "id": "p94.21",
            "order": 24,
            "type": "text",
            "bbox": {
                "l": 70.56,
                "t": 327.36,
                "r": 518.16,
                "b": 314.88
            },
            "text": "Starting Date of Experience: ___"
        },
        {
            "id": "p94.22",
            "order": 25,
            "type": "text",
            "bbox": {
                "l": 226.08,
                "t": 313.44,
                "r": 467.04,
                "b": 301.68
            },
            "text": "(First date possible you will be in this clinical setting)"
        },
        {
            "id": "p94.23",
            "order": 26,
            "type": "text",
            "bbox": {
                "l": 71.04,
                "t": 288.72,
                "r": 517.68,
                "b": 275.76
            },
            "text": "Anticipated Length of Experience: ___"
        },
        {
            "id": "p94.24",
            "order": 27,
            "type": "heading",
            "bbox": {
                "l": 71.04,
                "t": 263.28,
                "r": 246.48,
                "b": 250.56
            },
            "text": "Circle Correct Descriptor of Agency:",
            "attrs": {
                "block_label": "paragraph_title"
            },
            "level": 3
        },
        {
            "id": "p94.25",
            "order": 28,
            "type": "text",
            "bbox": {
                "l": 72,
                "t": 238.56,
                "r": 540.72,
                "b": 225.36
            },
            "text": "Rural Clinic Academic Medical Center Clinic"
        },
        {
            "id": "p94.26",
            "order": 29,
            "type": "text",
            "bbox": {
                "l": 396.48,
                "t": 238.56,
                "r": 538.08,
                "b": 225.84
            },
            "text": "Inner City Clinic School"
        },
        {
            "id": "p94.27",
            "order": 30,
            "type": "text",
            "bbox": {
                "l": 71.76,
                "t": 219.84,
                "r": 381.84,
                "b": 206.4
            },
            "text": "Specialty Clinic Private Practice Government Agency"
        },
        {
            "id": "p94.28",
            "order": 31,
            "type": "text",
            "bbox": {
                "l": 432.24,
                "t": 219.84,
                "r": 539.52,
                "b": 206.4
            },
            "text": "Hospital Church"
        },
        {
            "id": "p94.29",
            "order": 32,
            "type": "text",
            "bbox": {
                "l": 70.56,
                "t": 199.68,
                "r": 374.16,
                "b": 186
            },
            "text": "Public Health Department Clinic Hospital Professional Organizations Church"
        },
        {
            "id": "p94.30",
            "order": 33,
            "type": "text",
            "bbox": {
                "l": 71.04,
                "t": 179.28,
                "r": 300.96,
                "b": 167.04
            },
            "text": "Other ___"
        },
        {
            "id": "p94.31",
            "order": 34,
            "type": "text",
            "bbox": {
                "l": 431.28,
                "t": 199.44,
                "r": 538.32,
                "b": 185.76
            },
            "text": "Volunteer Organization"
        },
        {
            "id": "p94.32",
            "order": 35,
            "type": "heading",
            "bbox": {
                "l": 71.04,
                "t": 154.32,
                "r": 168,
                "b": 141.6
            },
            "text": "Type of Experience:",
            "attrs": {
                "block_label": "paragraph_title"
            },
            "level": 3
        },
        {
            "id": "p94.33",
            "order": 36,
            "type": "list",
            "bbox": {
                "l": 72.864,
                "t": 137.74496,
                "r": 134.26224,
                "b": 87.50832000000003
            },
            "text": "",
            "attrs": {
                "item_count": 4
            },
            "children": [
                {
                    "id": "p94.33.1",
                    "order": 37,
                    "type": "list_item",
                    "bbox": {
                        "l": 72.864,
                        "t": 137.74496,
                        "r": 134.26224,
                        "b": 125.55679999999995
                    },
                    "text": "□Educational",
                    "children": [
                        {
                            "id": "p94.33.1.1",
                            "order": 38,
                            "type": "form_field",
                            "bbox": {
                                "l": 72.86,
                                "t": 137.74,
                                "r": 84.86,
                                "b": 125.74
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "label": "□Educational",
                                "source": "glyph_estimate",
                                "bbox_estimated": true,
                                "label_source": "parent_text",
                                "label_ref": "p94.34.1",
                                "text_offset": 0,
                                "text_span": 1
                            }
                        }
                    ]
                },
                {
                    "id": "p94.33.2",
                    "order": 39,
                    "type": "list_item",
                    "bbox": {
                        "l": 82.584,
                        "t": 122.76031999999998,
                        "r": 116.8632,
                        "b": 112.82431999999994
                    },
                    "text": "Clinical",
                    "marker": "□",
                    "children": [
                        {
                            "id": "p94.33.2.1",
                            "order": 40,
                            "type": "form_field",
                            "bbox": {
                                "l": 82.58,
                                "t": 122.76,
                                "r": 92.52,
                                "b": 112.82
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "label": "Clinical",
                                "source": "glyph_estimate",
                                "bbox_estimated": true,
                                "label_source": "parent_text",
                                "label_ref": "p94.34.2",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p94.33.3",
                    "order": 41,
                    "type": "list_item",
                    "bbox": {
                        "l": 82.584,
                        "t": 110.16031999999996,
                        "r": 109.66512,
                        "b": 100.22432000000003
                    },
                    "text": "Direct",
                    "marker": "□",
                    "children": [
                        {
                            "id": "p94.33.3.1",
                            "order": 42,
                            "type": "form_field",
                            "bbox": {
                                "l": 82.58,
                                "t": 110.16,
                                "r": 92.52,
                                "b": 100.22
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "label": "Direct",
                                "source": "glyph_estimate",
                                "bbox_estimated": true,
                                "label_source": "parent_text",
                                "label_ref": "p94.34.3",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p94.33.4",
                    "order": 43,
                    "type": "list_item",
                    "bbox": {
                        "l": 82.584,
                        "t": 97.44431999999995,
                        "r": 116.13456,
                        "b": 87.50832000000003
                    },
                    "text": "Indirect",
                    "marker": "□",
                    "children": [
                        {
                            "id": "p94.33.4.1",
                            "order": 44,
                            "type": "form_field",
                            "bbox": {
                                "l": 82.58,
                                "t": 97.44,
                                "r": 92.52,
                                "b": 87.51
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "label": "Indirect",
                                "source": "glyph_estimate",
                                "bbox_estimated": true,
                                "label_source": "parent_text",
                                "label_ref": "p94.34.4",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        }
                    ]
                }
            ]
        }
    ],
    "excluded_furniture": {
        "first": [],
        "last": []
    }
}