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Date: VisitDateMonth -- 010203040506070809101112 / Day -- 01020304050607080910111213141516171819202122232425262728293031 / Year -- 2223

Time: Hour -- 010203040506070809101112 : Minute -- 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859   Meridiem -- AMPM

Entry ID: Input the first three digits - Input the digits after the first dash - Input the digit(s) after the second dash - Input the digitsafter the third dash - Input the digit(s) after the fourth dash - input the digit(s) after the fifth dash