For the following questions, use an ICD-9-CM code book and select the appropriate code(s) from the diagnostic statement given

In which of the following patients would nitroglycerin be contraindicated?

A. 41-year-old male with crushing chest pressure, a blood pressure of 160/90 mm Hg, and sever nausea B. 53-year old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Cialis C. 58-year old male with chest pain radiating to the left arm, a blood pressure of 130/64 mm Hg, and prescribed Tegretol D. 66-year-old female with chest pressure of 6 hours' durationi, lightheadedness, and a blood pressure of 110/58 mm Hg

Every form should include the ________ so that the form's use is obvious.

A. form name B. provider's name C. patient's chart number D. patient's name