https://i.imgur.com/TvmpR4O.png PREFERRED DEPARTMENT [X] Emergency Medicine [X] Internal Medicine [] Surgery [] Psychiatric 1. PERSONAL INFORMATION 1.1) Title: (select one) [] Mr. [] Mrs. [X] Ms. [] Mx. [] Other 1.2) First Name: Rowan 1.3) Middle Name: (optional) Diana 1.4) Last Name: McKnight 1.5)...