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                  <text>The Airline Industries was formed to better meet the needs of frequent international travellers. That is why we offer you , as an Airline Industries Gold member, worldwide privileges, a seamless experience, and convenient global access. Along with our consistent focus on safety and security, we provide tangible benefits every time you travel with an Airline Industries carrier.</text>
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                     <edge thickness="0.1524mm"/>
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                        <color value="0,0,0"/>
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                     <corner thickness="0.006in"/>
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               <field name="airline" x="72.39mm" w="81.28mm" h="12.7mm" y="2.54mm">
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                        <text>Airline</text>
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               <field name="flightDate" y="2.54mm" x="153.67mm" w="30.48mm" h="12.7mm">
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                           <edge presence="hidden">
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                           <edge presence="hidden">
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                        <text>Flight Date</text>
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                     <picture>MM/DD/YYYY</picture>
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                  <format>
                     <picture>MM/DD/YYYY</picture>
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                     <corner thickness="0.0762mm"/>
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                  <value>
                     <date/>
                  </value>
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               <field name="departTime" y="15.24mm" x="72.39mm" w="25.4mm" h="12.7mm">
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                           <edge thickness="0.0762mm" presence="hidden"/>
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                           <corner thickness="0.0762mm" presence="hidden">
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                  <caption reserve="5.08mm" placement="top">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
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                        <text>Departs</text>
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                  <bind>
                     <picture>h:MM A</picture>
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                  <format>
                     <picture>h:MM A</picture>
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                  <border>
                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
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                  <value>
                     <time/>
                  </value>
               </field>
               <field name="arriveTime" y="15.24mm" x="97.79mm" w="25.4mm" h="12.7mm">
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                     <dateTimeEdit>
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                           <edge presence="hidden"/>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <edge thickness="0.0762mm" presence="hidden"/>
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                           <corner thickness="0.0762mm" presence="hidden"/>
                           <corner thickness="0.0762mm" presence="hidden"/>
                           <corner thickness="0.0762mm" presence="hidden"/>
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                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <caption reserve="5.08mm" placement="top">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
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                        <text>Arrives</text>
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                  </caption>
                  <bind>
                     <picture>h:MM A</picture>
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                  <format>
                     <picture>h:MM A</picture>
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                  <value>
                     <time/>
                  </value>
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               <field name="gate" y="15.24mm" w="30.48mm" h="12.7mm" x="123.19mm">
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                           <edge presence="hidden">
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                           <corner thickness="0.0762mm"/>
                           <corner thickness="0.0762mm"/>
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                  <font typeface="Minion Pro" weight="bold"/>
                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <caption reserve="5.08mm" placement="top">
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                        <text>Gate</text>
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                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
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               </field>
               <field name="terminal" y="15.24mm" x="153.67mm" w="30.48mm" h="12.7mm">
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                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
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                           <corner thickness="0.0762mm"/>
                           <corner thickness="0.0762mm"/>
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                  <font typeface="Minion Pro" weight="bold"/>
                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
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                  <caption reserve="5.08mm" placement="top">
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                        <text>Terminal</text>
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               <draw name="Circle1" y="2.915mm" x="238.385mm" w="6.35mm" h="6.35mm" anchorType="middleCenter">
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                     <arc hand="right" circular="1">
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                           <color value="0,0,0"/>
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               <draw name="StaticText10" y="2.915mm" x="238.385mm" anchorType="middleCenter">
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                        <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>3</p></body>
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            <?templateDesigner expand 0?></subformSet>
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                  <text>CUSTOMS USE ONLY</text>
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            <draw name="StaticText12" y="11.43mm" x="88.9mm" anchorType="topCenter">
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                  <text>Welcome</text>
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                  <edge presence="hidden">
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                  <corner thickness="0.0762mm"/>
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            <draw name="Line1" y="16.51mm" x="48.26mm" w="27.94mm" h="0mm">
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            <draw name="Line1" y="16.51mm" x="101.6mm" w="27.94mm" h="0mm">
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            <draw name="StaticText13" y="17.78mm" x="88.9mm" anchorType="topCenter">
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                  <corner presence="hidden"/>
                  <corner presence="hidden"/>
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            <draw name="StaticText14" y="31.75mm" x="88.9mm" anchorType="topCenter">
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                        <edge presence="hidden">
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                     <text>1. Last Name</text>
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                        <edge presence="hidden">
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                     <text>2. FirstName</text>
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                        <edge thickness="0.0762mm" presence="hidden"/>
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                     <text>3. Middle Initial</text>
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                     <text>4. Country of Citizenship</text>
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               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" weight="bold" size="8pt"/>
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                     <text>5. Country of Residence</text>
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                  <edge thickness="0.0762mm"/>
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            <field name="birthDate" y="76.2mm" x="114.3mm" w="50.8mm" h="12.7mm">
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                        <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>6. Date of Birth<span style="xfa-spacerun:yes"> </span><span style="font-weight:normal">(YY/MM/DD)</span></p></body>
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                     <text>7. Number of Family Members  Traveling</text>
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            <field name="airlineFlightNum" y="88.9mm" x="88.9mm" w="76.2mm" h="12.7mm">
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                     <text>8. Airline Flight Number</text>
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            <field name="usAddress" y="101.6mm" x="12.7mm" w="152.4mm" h="12.7mm">
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                        <edge presence="hidden"/>
                        <edge thickness="0.0762mm" presence="hidden"/>
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                        <corner thickness="0.0762mm"/>
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                     <margin/>
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               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="10.8pt"/>
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                     <text>9. Address</text>
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            <field name="usCity" y="114.3mm" x="12.7mm" w="50.8mm" h="12.7mm">
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                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
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                        <edge thickness="0.0762mm" presence="hidden"/>
                        <corner thickness="0.0762mm"/>
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                     <margin/>
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               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
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                     <text>10. City</text>
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                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
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                     <text>11. State/Province</text>
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                        <edge presence="hidden"/>
                        <edge thickness="0.0762mm" presence="hidden"/>
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                        <corner thickness="0.0762mm"/>
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                     <text>12. Zip/Postal Code</text>
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            <exclGroup name="food" x="21.96mm" y="162.56mm">
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                     <text>d. The total value of all goods, including commercial merchandise, purchased or aquired abroad and bringing into the country.</text>
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                        <corner thickness="0.0762mm"/>
                        <corner presence="hidden"/>
                        <corner thickness="0.0762mm"/>
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                  <corner presence="hidden" thickness="0.003in"/>
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            <break startNew="1" before="pageArea" beforeTarget="#Page1"/>
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               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" posture="italic" size="8pt"/>
                  <value>
                     <text>Last Name</text>
                  </value>
               </caption>
               <bind match="global"/>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <field name="firstName" y="38.1mm" x="69.85mm" w="38.1mm" h="12.7mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" posture="italic" size="8pt"/>
                  <value>
                     <text>First Name</text>
                  </value>
               </caption>
               <bind match="global"/>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <field name="initial" y="38.1mm" x="107.95mm" w="38.1mm" h="12.7mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" posture="italic" size="8pt"/>
                  <value>
                     <text>Middle Initial</text>
                  </value>
               </caption>
               <bind match="global"/>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <field name="homeAddress" y="50.8mm" x="31.75mm" w="76.2mm" h="25.4mm">
               <ui>
                  <textEdit multiLine="1">
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para marginLeft="7.2pt"/>
               <caption reserve="5.08mm" placement="top">
                  <font size="8pt" typeface="Minion Pro" posture="italic"/>
                  <value>
                     <text>Home Address</text>
                  </value>
               </caption>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
               <bind match="none"/>
               <event activity="ready" ref="$form">
                  <script contentType="application/x-javascript">// Concatenate the address information.

this.rawValue =	$record.address.value + '\u000a' +
				$record.city.value + ', ' + $record.state.value + ', ' + $record.zipCode.value;</script>
               </event>
            </field>
            <field name="phoneNum" y="50.8mm" w="38.1mm" h="12.7mm" x="107.95mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" posture="italic" size="8pt"/>
                  <value>
                     <text>Phone Number</text>
                  </value>
               </caption>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <field name="mobileNum" y="63.5mm" w="38.1mm" h="12.7mm" x="107.95mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" posture="italic" size="8pt"/>
                  <value>
                     <text>Mobile Number</text>
                  </value>
               </caption>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <field name="SSN" y="76.2mm" x="31.75mm" w="38.1mm" h="12.7mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" posture="italic" size="8pt"/>
                  <value>
                     <text>SSN</text>
                  </value>
               </caption>
               <bind match="global"/>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
               <format>
                  <picture>999-99-9999</picture>
               </format>
            </field>
            <field name="birthDate" y="76.2mm" x="69.85mm" w="38.1mm" h="12.7mm">
               <ui>
                  <dateTimeEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </dateTimeEdit>
               </ui>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
               <caption reserve="5.08mm" placement="top">
                  <font typeface="Minion Pro" posture="italic" size="8pt"/>
                  <value>
                     <text>Date of Birth</text>
                  </value>
               </caption>
               <bind match="global">
                  <picture>MM/DD/YYYY</picture>
               </bind>
               <format>
                  <picture>MMMM D, YYYY</picture>
               </format>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
               <value>
                  <date/>
               </value>
            </field>
            <draw name="StaticText24" y="76.2mm" x="107.95mm" w="38.1mm" h="12.7mm">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <text>Sex</text>
               </value>
               <font typeface="Minion Pro" posture="italic" size="8pt"/>
               <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.0762mm"/>
               </border>
               <?renderCache.bounds 105192 33192 0 0 2808 2808 0 0?>
               <?renderCache.textRun 3 Sex 0 2808 8624 0 0 0 "Minion Pro" 0 1 8000 ISO-8859-1?></draw>
            <exclGroup name="sex" x="113.03mm" y="81.28mm">
               <field w="15.24mm" h="6.35mm" name="female">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                        </border>
                        <margin/>
                     </checkButton>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption reserve="10.16mm" placement="right">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <para vAlign="middle" marginLeft="0pt"/>
                     <value>
                        <text>Female</text>
                     </value>
                  </caption>
                  <items>
                     <integer>1</integer>
                  </items>
               </field>
               <field x="17.78mm" w="12.7mm" h="6.35mm" name="male">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption placement="right" reserve="7.62mm">
                     <para vAlign="middle"/>
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <value>
                        <text>Male</text>
                     </value>
                  </caption>
                  <items>
                     <integer>2</integer>
                  </items>
               </field>
               <?templateDesigner expand 0?></exclGroup>
            <draw name="StaticText25" y="106.68mm" x="31.75mm" minH="0mm" w="114.3mm">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <text>Medical Information</text>
               </value>
               <font size="12pt" typeface="Minion Pro" posture="italic" weight="bold"/>
               <margin topInset="0mm" bottomInset="2.54mm" leftInset="0mm" rightInset="0mm"/>
               <border>
                  <edge thickness="0.0762mm" presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm" presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge thickness="0.0762mm" presence="hidden"/>
                  <corner thickness="0.003in" presence="hidden">
                  </corner>
                  <corner thickness="0.003in" presence="hidden">
                  </corner>
                  <corner thickness="0.003in"/>
                  <corner thickness="0.003in" presence="hidden"/>
               </border>
            </draw>
            <draw name="StaticText26" y="118.11mm" x="62.23mm" minH="0mm" minW="0mm">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <text>Yes</text>
               </value>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" hAlign="center"/>
               <border>
                  <edge thickness="0.0762mm" presence="hidden"/>
                  <corner thickness="0.003in" presence="hidden"/>
               </border>
            </draw>
            <draw name="StaticText27" y="118.11mm" x="73.66mm" minH="0mm" minW="0mm">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <text>No</text>
               </value>
               <font typeface="Minion Pro" weight="bold"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" hAlign="center"/>
               <border>
                  <edge thickness="0.0762mm" presence="hidden"/>
                  <corner thickness="0.003in" presence="hidden"/>
               </border>
            </draw>
            <exclGroup name="asthma" x="38.1mm" y="127mm" w="39.37mm">
               <field y="0mm" x="0mm" w="33.02mm" h="7.62mm" name="yes">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                        </border>
                        <margin/>
                     </checkButton>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption reserve="25.4mm">
                     <font typeface="Minion Pro" posture="italic"/>
                     <para vAlign="middle" marginLeft="0pt" marginRight="0pt"/>
                     <value>
                        <exData contentType="text/html" maxLength="0">
                           <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>Asthma</p></body>
                        </exData>
                     </value>
                  </caption>
                  <items>
                     <integer>1</integer>
                  </items>
               </field>
               <field y="0mm" x="33.02mm" w="6.35mm" h="7.62mm" name="no">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <items>
                     <integer>2</integer>
                  </items>
               </field>
               <?templateDesigner expand 0?></exclGroup>
            <field name="asthmaNotes" y="127mm" x="82.55mm" w="63.5mm" h="7.62mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm" presence="hidden"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="3.6pt"/>
               <border>
                  <edge presence="hidden">
                  </edge>
                  <edge presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge presence="hidden"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <exclGroup name="diabetes" x="38.1mm" y="134.62mm" w="39.37mm">
               <field x="0mm" w="33.02mm" h="7.62mm" name="yes" y="0mm">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                        </border>
                        <margin/>
                     </checkButton>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption reserve="25.4mm">
                     <font typeface="Minion Pro" posture="italic"/>
                     <para vAlign="middle" marginLeft="0pt" marginRight="0pt"/>
                     <value>
                        <exData contentType="text/html" maxLength="0">
                           <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>Diabetes</p></body>
                        </exData>
                     </value>
                  </caption>
                  <items>
                     <integer>1</integer>
                  </items>
               </field>
               <field y="0mm" x="33.02mm" w="6.35mm" h="7.62mm" name="no">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <items>
                     <integer>2</integer>
                  </items>
               </field>
               <?templateDesigner expand 0?></exclGroup>
            <field name="diabetesNotes" y="134.62mm" x="82.55mm" w="63.5mm" h="7.62mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm" presence="hidden"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="3.6pt"/>
               <border>
                  <edge presence="hidden">
                  </edge>
                  <edge presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge presence="hidden"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <exclGroup name="seizure" x="38.1mm" y="142.24mm" w="39.37mm">
               <field y="0mm" x="0mm" w="33.02mm" h="7.62mm" name="yes">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                        </border>
                        <margin/>
                     </checkButton>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption reserve="25.4mm">
                     <font typeface="Minion Pro" posture="italic"/>
                     <para vAlign="middle" marginLeft="0pt" marginRight="0pt"/>
                     <value>
                        <exData contentType="text/html" maxLength="0">
                           <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>Seizure Disorder</p></body>
                        </exData>
                     </value>
                  </caption>
                  <items>
                     <integer>1</integer>
                  </items>
               </field>
               <field y="0mm" x="33.02mm" w="6.35mm" h="7.62mm" name="no">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <items>
                     <integer>2</integer>
                  </items>
               </field>
               <?templateDesigner expand 0?></exclGroup>
            <field name="seizureNotes" y="142.24mm" x="82.55mm" w="63.5mm" h="7.62mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm" presence="hidden"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="3.6pt"/>
               <border>
                  <edge presence="hidden">
                  </edge>
                  <edge presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge presence="hidden"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <exclGroup name="heart" x="38.1mm" y="149.86mm" w="39.37mm">
               <field y="0mm" x="0mm" w="33.02mm" h="7.62mm" name="yes">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                        </border>
                        <margin/>
                     </checkButton>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption reserve="25.4mm">
                     <font typeface="Minion Pro" posture="italic"/>
                     <para vAlign="middle" marginLeft="0pt" marginRight="0pt"/>
                     <value>
                        <exData contentType="text/html" maxLength="0">
                           <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>Heart Disease</p></body>
                        </exData>
                     </value>
                  </caption>
                  <items>
                     <integer>1</integer>
                  </items>
               </field>
               <field y="0mm" x="33.02mm" w="6.35mm" h="7.62mm" name="no">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <items>
                     <integer>2</integer>
                  </items>
               </field>
               <?templateDesigner expand 0?></exclGroup>
            <field name="heartNotes" y="149.86mm" x="82.55mm" w="63.5mm" h="7.62mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm" presence="hidden"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="3.6pt"/>
               <border>
                  <edge presence="hidden">
                  </edge>
                  <edge presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge presence="hidden"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <exclGroup name="hypertension" x="38.1mm" y="149.86mm" w="39.37mm">
               <field y="7.62mm" x="0mm" w="33.02mm" h="7.62mm" name="yes">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                        </border>
                        <margin/>
                     </checkButton>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption reserve="25.4mm">
                     <font typeface="Minion Pro" posture="italic"/>
                     <para vAlign="middle" marginLeft="0pt" marginRight="0pt"/>
                     <value>
                        <exData contentType="text/html" maxLength="0">
                           <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>Hypertension</p></body>
                        </exData>
                     </value>
                  </caption>
                  <items>
                     <integer>1</integer>
                  </items>
               </field>
               <field y="7.62mm" x="33.02mm" w="6.35mm" h="7.62mm" name="no">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <items>
                     <integer>2</integer>
                  </items>
               </field>
               <?templateDesigner expand 0?></exclGroup>
            <field name="hyperNotes" y="157.48mm" x="82.55mm" w="63.5mm" h="7.62mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm" presence="hidden"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="3.6pt"/>
               <border>
                  <edge presence="hidden">
                  </edge>
                  <edge presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge presence="hidden"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <exclGroup name="pregnant" x="38.1mm" y="165.1mm" w="39.37mm">
               <field y="0mm" x="0mm" w="33.02mm" h="7.62mm" name="yes">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <caption reserve="25.4mm">
                     <para vAlign="middle" marginLeft="0pt" marginRight="0pt"/>
                     <font typeface="Minion Pro" posture="italic"/>
                     <value>
                        <text>Pregnancy</text>
                     </value>
                  </caption>
                  <items>
                     <integer>1</integer>
                  </items>
               </field>
               <field y="0mm" x="33.02mm" w="6.35mm" h="7.62mm" name="no">
                  <ui>
                     <checkButton shape="round">
                        <border>
                           <edge/>
                           <fill/>
                        </border>
                     </checkButton>
                  </ui>
                  <font size="8pt" typeface="Minion Pro"/>
                  <margin leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <items>
                     <integer>2</integer>
                  </items>
               </field>
               <?templateDesigner expand 0?></exclGroup>
            <field name="pregnantMonths" y="165.1mm" x="82.55mm" w="63.5mm" h="7.62mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm" presence="hidden"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="3.6pt"/>
               <border>
                  <edge presence="hidden">
                  </edge>
                  <edge presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge presence="hidden"/>
                  <corner thickness="0.0762mm"/>
               </border>
            </field>
            <draw name="StaticText28" y="190.5mm" x="31.75mm" minH="0mm" w="114.3mm">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <text>Insurance Information</text>
               </value>
               <font size="12pt" typeface="Minion Pro" posture="italic" weight="bold"/>
               <margin topInset="0mm" bottomInset="2.54mm" leftInset="0mm" rightInset="0mm"/>
               <border>
                  <edge thickness="0.0762mm" presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm" presence="hidden">
                  </edge>
                  <edge thickness="0.0762mm"/>
                  <edge thickness="0.0762mm" presence="hidden"/>
                  <corner thickness="0.003in" presence="hidden">
                  </corner>
                  <corner thickness="0.003in" presence="hidden">
                  </corner>
                  <corner thickness="0.003in"/>
                  <corner thickness="0.003in" presence="hidden"/>
               </border>
            </draw>
            <field name="insuranceCompany" y="198.12mm" x="62.23mm" w="83.82mm" h="7.62mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="7.2pt"/>
               <caption reserve="38.1mm">
                  <font typeface="Minion Pro" posture="italic"/>
                  <para vAlign="middle" hAlign="right" marginRight="7.2pt"/>
                  <value>
                     <text>Insurance Company</text>
                  </value>
               </caption>
            </field>
            <field name="insuranceAddress" y="205.74mm" x="62.23mm" w="83.82mm" h="6.35mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="7.2pt"/>
               <caption reserve="38.1mm">
                  <font typeface="Minion Pro" posture="italic"/>
                  <para vAlign="middle" hAlign="right" marginRight="7.2pt"/>
                  <value>
                     <text>Address</text>
                  </value>
               </caption>
            </field>
            <field name="insuranceCityStateZip" y="212.09mm" x="100.33mm" w="45.72mm" h="6.35mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                        <edge presence="hidden">
                        </edge>
                        <edge thickness="0.0762mm"/>
                        <edge presence="hidden"/>
                        <corner thickness="0.0762mm"/>
                     </border>
                     <margin/>
                  </textEdit>
               </ui>
               <font typeface="Minion Pro"/>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <para vAlign="middle" marginLeft="7.2pt"/>
            </field>
            <break startNew="1" before="pageArea" beforeTarget="#Page1"/>
            <draw name="Circle1" y="3.175mm" x="174.885mm" w="6.35mm" h="6.35mm" anchorType="middleCenter">
               <value>
                  <arc hand="right" circular="1">
                     <fill>
                        <color value="0,0,0"/>
                     </fill>
                  </arc>
               </value>
               <para vAlign="middle" hAlign="center"/>
            </draw>
            <draw name="StaticText29" y="3.175mm" x="174.885mm" anchorType="middleCenter">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <text>5</text>
               </value>
               <font size="12pt" typeface="Minion Pro" weight="bold">
                  <fill>
                     <color value="255,255,255"/>
                  </fill>
               </font>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
            </draw>
            <?templateDesigner expand 0?></subform>
         <subformSet name="accommodation">
            <occur min="0" max="-1"/>
            <subform name="hotelHeader" w="241.3mm" id="hotelHeader">
               <occur max="-1"/>
               <field name="reservationBroker" y="0mm" x="0mm" w="212.09mm" h="12.7mm">
                  <ui>
                     <textEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" size="16pt"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt"/>
                  <bind match="global"/>
                  <border>
                     <edge presence="hidden">
                     </edge>
                     <edge presence="hidden">
                     </edge>
                     <edge thickness="0.0762mm"/>
                     <edge presence="hidden"/>
                     <corner thickness="0.0762mm"/>
                  </border>
               </field>
               <field name="reservationRef" y="2.54mm" x="212.09mm" w="25.4mm" h="7.62mm" anchorType="topRight" access="nonInteractive">
                  <ui>
                     <barcode type="code3Of9" wideNarrowRatio="3.0" textLocation="none" dataLength="5"/>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <value>
                     <text>12345</text>
                  </value>
                  <bind match="global"/>
               </field>
               <break before="pageArea" beforeTarget="#Page2"/>
               <field name="guestName" y="12.7mm" x="0mm" h="10.16mm" minW="76.2mm">
                  <ui>
                     <textEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" size="16pt"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt"/>
                  <bind match="global"/>
                  <event activity="ready" ref="$form">
                     <script contentType="application/x-javascript">// Concatenate the names.

this.rawValue =	$record.lastName.value + ' ' + $record.firstName.value;</script>
                  </event>
               </field>
               <field name="guestAddress" y="22.86mm" x="0mm" w="76.2mm" minH="6.35mm">
                  <ui>
                     <textEdit multiLine="1">
                        <border>
                           <edge presence="hidden">
                           </edge>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt"/>
                  <bind match="global"/>
                  <event activity="ready" ref="$form">
                     <script contentType="application/x-javascript">// Concatenate the address information.

this.rawValue =	$record.address.value + '\u000a' +
				$record.city.value + ', ' + $record.state.value + ', ' + $record.zipCode.value;</script>
                  </event>
               </field>
               <field name="reservationRef" y="12.7mm" x="212.09mm" w="25.4mm" h="10.16mm" anchorType="topRight">
                  <ui>
                     <textEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" size="16pt"/>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <bind match="global"/>
               </field>
               <draw name="Circle1" y="3.175mm" x="238.385mm" w="6.35mm" h="6.35mm" anchorType="middleCenter">
                  <value>
                     <arc hand="right" circular="1">
                        <fill>
                           <color value="0,0,0"/>
                        </fill>
                     </arc>
                  </value>
                  <para vAlign="middle" hAlign="center"/>
               </draw>
               <draw name="StaticText30" y="3.175mm" x="238.385mm" anchorType="middleCenter">
                  <ui>
                     <textEdit>
                     </textEdit>
                  </ui>
                  <value>
                     <text>6</text>
                  </value>
                  <font size="12pt" typeface="Minion Pro" weight="bold">
                     <fill>
                        <color value="255,255,255"/>
                     </fill>
                  </font>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               </draw>
               <?templateDesigner expand 0?></subform>
            <subform name="hotel" w="241.3mm" x="0mm" y="0mm">
               <occur max="-1" min="0"/>
               <margin leftInset="0mm" rightInset="0mm" topInset="6.35mm" bottomInset="0mm"/>
               <field name="hotelName" y="0mm" w="69.85mm" h="7.62mm">
                  <ui>
                     <textEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font size="12pt" typeface="Minion Pro">
                     <fill>
                        <color value="255,255,255"/>
                     </fill>
                  </font>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="1mm" rightInset="0mm"/>
                  <para vAlign="middle"/>
                  <border>
                     <edge/>
                     <fill>
                        <color value="0,0,0"/>
                     </fill>
                     <corner thickness="0.006in"/>
                  </border>
               </field>
               <draw name="Rectangle1" y="0mm" x="69.85mm" w="116.84mm" h="0.508mm">
                  <value>
                     <rectangle>
                        <edge/>
                        <fill>
                           <color value="0,0,0"/>
                        </fill>
                     </rectangle>
                  </value>
               </draw>
               <field name="reservationNum" w="25.4mm" h="7.62mm" x="186.69mm" y="0mm">
                  <ui>
                     <textEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <corner presence="hidden"/>
                           <corner thickness="0.0762mm"/>
                           <corner/>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" size="12pt">
                     <fill>
                        <color value="255,255,255"/>
                     </fill>
                  </font>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <border>
                     <edge thickness="0.1524mm"/>
                     <corner thickness="0.1524mm"/>
                     <fill>
                        <color value="0,0,0"/>
                     </fill>
                  </border>
               </field>
               <field name="hotelAddress" x="72.39mm" w="60.96mm" h="20.32mm" y="2.54mm">
                  <ui>
                     <textEdit multiLine="1">
                        <border>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <corner presence="hidden"/>
                           <corner thickness="0.0762mm"/>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" weight="bold"/>
                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
                  <para marginLeft="7.2pt"/>
                  <caption reserve="5.08mm" placement="top">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <para marginRight="0pt"/>
                     <value>
                        <text>Hotel Address</text>
                     </value>
                  </caption>
                  <border>
                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
                  </border>
               </field>
               <field name="roomName" y="2.54mm" x="133.35mm" w="50.8mm" h="20.32mm">
                  <ui>
                     <textEdit multiLine="1">
                        <border>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <corner presence="hidden"/>
                           <corner thickness="0.0762mm"/>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" weight="bold"/>
                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
                  <para marginLeft="7.2pt"/>
                  <caption reserve="5.08mm" placement="top">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <para marginRight="0pt"/>
                     <value>
                        <text>Room Type</text>
                     </value>
                  </caption>
                  <border>
                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
                  </border>
                  <bind match="none"/>
                  <event activity="ready" ref="$form">
                     <script contentType="application/x-javascript">// Concatenate the room information.

this.rawValue =	$record.hotel.roomType.value + '\u000a' +
				$record.hotel.room.value;</script>
                  </event>
               </field>
               <field name="hotelPhoneNum" y="22.86mm" x="72.39mm" w="60.96mm" h="12.7mm">
                  <ui>
                     <textEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <corner presence="hidden"/>
                           <corner thickness="0.0762mm"/>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" weight="bold"/>
                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <caption reserve="5.08mm" placement="top">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <para marginRight="0pt"/>
                     <value>
                        <text>Hotel Phone Number</text>
                     </value>
                  </caption>
                  <border>
                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
                  </border>
               </field>
               <field name="arrivalDate" y="22.86mm" x="133.35mm" w="25.4mm" h="12.7mm">
                  <ui>
                     <dateTimeEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <corner presence="hidden"/>
                           <corner thickness="0.0762mm"/>
                        </border>
                        <margin/>
                     </dateTimeEdit>
                  </ui>
                  <font typeface="Minion Pro" weight="bold"/>
                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <caption reserve="5.08mm" placement="top">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <para marginRight="0pt"/>
                     <value>
                        <text>Arrival</text>
                     </value>
                  </caption>
                  <border>
                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
                  </border>
                  <bind>
                     <picture>MM/DD/YYYY</picture>
                  </bind>
                  <format>
                     <picture>MM/DD/YYYY</picture>
                  </format>
                  <value>
                     <date/>
                  </value>
               </field>
               <field name="departureDate" y="22.86mm" x="158.75mm" w="25.4mm" h="12.7mm">
                  <ui>
                     <dateTimeEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <corner presence="hidden"/>
                           <corner thickness="0.0762mm"/>
                        </border>
                        <margin/>
                     </dateTimeEdit>
                  </ui>
                  <font typeface="Minion Pro" weight="bold"/>
                  <margin topInset="0.9906mm" bottomInset="0mm" leftInset="0.9906mm" rightInset="0mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <caption reserve="5.08mm" placement="top">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <para marginRight="0pt"/>
                     <value>
                        <text>Departure</text>
                     </value>
                  </caption>
                  <bind>
                     <picture>MM/DD/YYYY</picture>
                  </bind>
                  <format>
                     <picture>MM/DD/YYYY</picture>
                  </format>
                  <border>
                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
                  </border>
                  <value>
                     <date/>
                  </value>
               </field>
               <field name="nights" y="11.43mm" w="17.78mm" x="190.5mm" h="17.78mm">
                  <ui>
                     <textEdit>
                        <border>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge presence="hidden">
                           </edge>
                           <edge thickness="0.0762mm" presence="hidden"/>
                           <corner presence="hidden"/>
                           <corner thickness="0.0762mm"/>
                        </border>
                        <margin/>
                     </textEdit>
                  </ui>
                  <font typeface="Minion Pro" size="20pt"/>
                  <margin topInset="0mm" bottomInset="0.762mm" leftInset="0mm" rightInset="0.762mm"/>
                  <para vAlign="middle" marginLeft="0pt" hAlign="center"/>
                  <caption reserve="3.81mm" placement="bottom">
                     <font typeface="Minion Pro" posture="italic" size="8pt"/>
                     <para marginRight="0pt" hAlign="right" vAlign="bottom"/>
                     <value>
                        <exData contentType="text/html" maxLength="0">
                           <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4042.0"><p>Night(s)</p></body>
                        </exData>
                     </value>
                  </caption>
                  <border>
                     <edge thickness="0.0762mm"/>
                     <corner thickness="0.0762mm"/>
                  </border>
               </field>
               <draw name="Circle1" y="2.915mm" x="238.385mm" w="6.35mm" h="6.35mm" anchorType="middleCenter">
                  <value>
                     <arc hand="right" circular="1">
                        <fill>
                           <color value="0,0,0"/>
                        </fill>
                     </arc>
                  </value>
                  <para vAlign="middle" hAlign="center"/>
               </draw>
               <draw name="StaticText31" y="2.915mm" x="238.385mm" anchorType="middleCenter">
                  <ui>
                     <textEdit>
                     </textEdit>
                  </ui>
                  <value>
                     <text>7</text>
                  </value>
                  <font size="12pt" typeface="Minion Pro" weight="bold">
                     <fill>
                        <color value="255,255,255"/>
                     </fill>
                  </font>
                  <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               </draw>
               <break overflowLeader="#hotelHeader"/>
               <?templateDesigner expand 0?></subform>
            <?templateDesigner expand 0?></subformSet>
         <subform name="boarding" x="0mm" y="92.6mm" w="241.3mm">
            <occur max="-1" min="0"/>
            <draw name="StaticText32" y="0mm" x="31.75mm" w="5in" h="3in">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <exData contentType="text/html" maxLength="0">
                     <body xmlns="http://www.w3.org/1999/xhtml" xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/" xfa:APIVersion="1.4.4036.0"><p>Thank you for choosing Airline Industries</p></body>
                  </exData>
               </value>
               <font size="12pt" typeface="Minion Pro" weight="bold" posture="italic"/>
               <margin topInset="0mm" bottomInset="2.54mm" leftInset="0mm" rightInset="6.35mm"/>
               <para vAlign="bottom" hAlign="right"/>
               <border>
                  <edge thickness="0.0762mm"/>
                  <corner thickness="0.003in" join="round" radius="6.35mm"/>
               </border>
               <?renderCache.bounds 342000 208800 0 0 0 0 0 0?>
               <?renderCache.textRun 41 Thank you for choosing Airline Industries 0 137115 205524 0 0 0 "Minion Pro" 1 1 12000 ISO-8859-1?></draw>
            <draw name="StaticText33" y="76.2mm" x="31.75mm" w="76.2mm" rotate="90" h="12.7mm">
               <ui>
                  <textEdit>
                  </textEdit>
               </ui>
               <value>
                  <text>Boarding Pass</text>
               </value>
               <font size="30pt" typeface="Minion Pro">
                  <fill>
                     <color value="255,255,255"/>
                  </fill>
               </font>
               <margin topInset="0mm" bottomInset="0mm" leftInset="0mm" rightInset="0mm"/>
               <border>
                  <edge thickness="0.1524mm"/>
                  <corner thickness="0.1524mm" radius="6.35mm"/>
                  <fill>
                     <color value="0,0,0"/>
                  </fill>
               </border>
               <para hAlign="center" vAlign="middle"/>
               <?renderCache.bounds 36000 216000 0 0 0 -216000 0 0?>
               <?renderCache.textRun 13 Boarding Pass 0 24810 193229 255 255 255 "Minion Pro" 0 0 30000 ISO-8859-1?></draw>
            <field name="lastName" y="0mm" x="44.45mm" w="38.1mm" h="12.7mm">
               <ui>
                  <textEdit>
                     <border>
                        <edge presence="hidden">
                        </edge>
                     </border>
                     <margin/>
                  </textEdit>
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