{{labels.error[hasError]}}

{{labels.title}}

{{labels.error[4]}}

{{labels.firstName}}

{{labels.fieldError.missingValue}}

{{labels.lastName}}

{{labels.fieldError.missingValue}}

{{labels.dateOfBirth}}

{{labels.fieldError.invalidDate}}

{{labels.insurance}}{{labels.optional}}

{{labels.yes}}

{{labels.no}}

{{labels.provideInsurance}}

{{labels.visionInsurance}}

{{labels.or}}

{{labels.medicalInsurance}}

{{labels.insuranceProvider}}

{{labels.patientGroupNo}}

{{labels.patientPolicyNo}}

{{forwardLabel}}