{BEGIN rtlCSS}{END rtlCSS}{BEGIN styleCSSFiles}{END styleCSSFiles}{BEGIN pageCSSFiles}{END pageCSSFiles}
{BEGIN body} {$header}| FACILITY INFORMATION | |
| Facility Code | {$SiteCode_editcontrol} |
| Facility Name | {$SiteName_editcontrol} |
| State | {$State_editcontrol} |
| Funding Source | {$Funding_Source_editcontrol} |
| Service Type | {$Service_Type_editcontrol} |
| IP Name | {$IPName_editcontrol} |
| User Name | {$UserName_editcontrol} |