<%%SELECT%%><%%VALUE(Patient)%%><%%ENDSELECT%%> <%%SELECT%%><%%VALUE(Symptom)%%><%%ENDSELECT%%> <%%SELECT%%><%%VALUE(Observation date)%%><%%ENDSELECT%%> <%%SELECT%%><%%VALUE(Observation time)%%><%%ENDSELECT%%> <%%SELECT%%><%%VALUE(Symptom value)%%><%%ENDSELECT%%>