Birthdate Entry Text Normal Abnormal General Normal Abnormal Skin Normal Abnormal Eyes Normal Abnormal Ears Normal Abnormal Mouth / Throat Normal Abnormal Cardiovascular Normal Abnormal Lungs / Chest Normal Abnormal Abdomen Normal Abnormal GU / Hernias Normal Abnormal Back / Spine Normal Abnormal Extremities Normal Abnormal Neuro / Reflex Normal Abnormal Gait Normal Abnormal Vascular Normal Abnormal General Observation Markedly OverweightTremorAffect / AppearanceDemeanorAbnormal PostureDistressedDrowsyPoorly DevelopedCustom / Other Observation Details General Statement: plus minus Extremities Side RL Extremity ArmWristHandFingerLegKneeFootToeCustom / Other Extremity Observation ImpairedDeformedAtrophyAmputationProstheticBraceTendernessFlaccidityStiffnessCustom / Other Observation Details General Statement: plus minus Observations Summary: Submit If you are human, leave this field blank. More Info Transfer Birthdate from Text Field The original date field is now hidden on the driver intake form. In its place there is a single line text field with standard formatting applied ‘##/##/####’ . The value is copied over to the hidden date field.