Year: #= ReportYear != null ? ReportYear : '' #
Doc Type: #= DocumentType != null ? DocumentType : '' #
Doc Name: #= ReportType != null ? ReportType : '' #
Amend: #= IsAmendment != null ? IsAmendment : '' #
Received Image: #= ImageReceiptDate != null ? ImageReceiptDate : '' #
Received Data: #= DataImportDate != null ? DataImportDate : '' #
Start Date: #= PeriodStartDate != null ? PeriodStartDate : '' #
End Date: #= PeriodEndDate != null ? PeriodEndDate : '' #
Image: # if (ImageType && ImageLink) { ##= ImageType ## } #
Data: # if (DataType && DataLink) { var _rn = [ReportYear, ReportType].filter(Boolean).join(' '); ##= DataType ## } #

NC CHIROPRACTIC ASSN INC PAC [STA-3JDSUI-C-001]