c5b1f7699f9a050cb64aefb21022bbf3  oyae334_1.pdf
4b3ca2886e1eb8ff2b9c8d162265489ade4b49db  oyae334_1.pdf
3bb03d3f6a2cb1390e67e2db8d41f98761cb98317c9a5a79348217f94816835d  oyae334_1.pdf

Title:           Characterization of thrombosis risk in ambulatory patients with cancer: results of the observational, prospective, multicenter CARTAGO study
Subject:         DOI: 10.1093/oncolo/oyae334
The Oncologist, Volume. 30, Issue. 8, 2 December 2024
Abstract 
Background:  Venous thromboembolism (VTE) is one of the leading causes of death in patients with cancer. Currently, there is a need to develop an easily applicable risk model that can identify patients who will benefit from receiving primary thromboprophylaxis to reduce the incidence of VTE.
Patients and methods:  This was a non-interventional, multicenter, observational, prospective study carried out in 62 Oncology and Hematology services in Spain and Portugal between January 2018 and December 2019. The main objective of the CARTAGO study was to develop a predictive model within a competitive risk framework to assess the risk of VTE in patients with cancer undergoing chemotherapy, biological, or hormonal treatment.
Results:  A total of 1596 patients were analyzed. VTE events occurred in 124 (8%) during the 6-month follow-up period (42% of deep vein thrombosis [DVT], 48% of pulmonary embolism [PE], and 10% of both DVT and PE). Four variables were selected for the multivariate predictive model to determine the risk of VTE (tumor type, D-dimer, compression of a vessel by the tumor, and leukocyte count). The 4 variables were associated with an increased risk of VTE (C-statistic, 0.646 [95%CI, 0.620-0.673]). The most significant variables in the internal validation with bootstrapping were the "very high risk" tumors (hazard ratio [HR] 2.032; 95%CI, 1.287-3.211).
Conclusion:  The CARTAGO model predicts the VTE risk in patients with cancer receiving anticancer therapy in an outpatient setting. This model can easily aid in identifying ambulatory patients who would probably benefit from primary thromboprophylaxis.
Author:          Javier Trujillo-Santos
Creator:         Adobe InDesign 15.1 (Windows)
Producer:        Adobe PDF Library 15.0
CreationDate:    Fri Aug 29 07:28:22 2025 CEST
ModDate:         Fri Aug 29 07:29:52 2025 CEST
Custom Metadata: no
Metadata Stream: yes
Tagged:          yes
UserProperties:  no
Suspects:        no
Form:            none
JavaScript:      no
Pages:           11
Encrypted:       no
Page size:       595.276 x 782.362 pts
Page rot:        0
File size:       982870 bytes
Optimized:       yes
PDF version:     1.4


name                                 type              encoding         emb sub uni object ID
------------------------------------ ----------------- ---------------- --- --- --- ---------
TKTCKM+UniversLTStd-CnObl            Type 1C           WinAnsi          yes yes yes   2271  0
XYUAOE+UniversLTStd-Cn               Type 1C           WinAnsi          yes yes yes   2272  0
ADCIEY+UniversLTStd-BoldCn           Type 1C           WinAnsi          yes yes yes   2273  0
UCDYYK+UniversLTStd-Bold             Type 1C           Custom           yes yes yes   2274  0
ZCMXQA+MyriadPro-Bold                Type 1C           WinAnsi          yes yes yes   2275  0
RQLBIQ+MyriadPro-Regular             Type 1C           WinAnsi          yes yes yes   2288  0
KDZLOE+UniversLTStd-Light            Type 1C           Custom           yes yes yes   2289  0
ZFGNQA+SabonLTStd-Roman              Type 1C           Custom           yes yes yes   2290  0
OFMPSW+UniversLTStd-Obl              Type 1C           WinAnsi          yes yes yes    212  0
ZGZYQA+UniversLTStd                  Type 1C           WinAnsi          yes yes yes    207  0
ANMEEY+SabonLTStd-Italic             Type 1C           WinAnsi          yes yes yes    217  0
AIIZZY+SabonLTStd-Bold               Type 1C           WinAnsi          yes yes yes    228  0
OGFANW+SabonLTStd-BoldItalic         Type 1C           WinAnsi          yes yes yes    229  0


Jhove (Rel. 1.28.0, 2023-05-18)
 Date: 2026-03-05 04:19:30 CET
 RepresentationInformation: oyae334_1.pdf
  ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16)
  LastModified: 2026-03-04 16:37:40 CET
  Size: 982870
  Format: PDF
  Version: 1.4
  Status: Well-Formed and valid
  SignatureMatches:
   PDF-hul
  MIMEtype: application/pdf
  Profile: Linearized PDF, Tagged PDF
  PDFMetadata: 
   Objects: 2396
   FreeObjects: 1
   IncrementalUpdates: 1
   DocumentCatalog: 
    ViewerPreferences: 
     HideToolbar: false
     HideMenubar: false
     HideWindowUI: false
     FitWindow: false
     CenterWindow: false
     DisplayDocTitle: true
     NonFullScreenPageMode: UseNone
     Direction: L2R
     ViewArea: CropBox
     ViewClip: CropBox
     PrintArea: CropBox
     PageClip: CropBox
    PageLayout: OneColumn
    PageMode: UseOutlines
    Language: en-US
    Outlines: 
     Item: 
      Title: Characterization of thrombosis risk in ambulatory patients with cancer: results of the observational, prospective, multicenter CARTAGO study
      Children: 
       Item: 
        Title: Introduction
       Item: 
        Title: Patients and methods
        Children: 
         Item: 
          Title: Study design
         Item: 
          Title: Patient selection
         Item: 
          Title: Study objectives and procedures
         Item: 
          Title: Statistical analysis
       Item: 
        Title: Results
        Children: 
         Item: 
          Title: Patient characteristics at baseline
         Item: 
          Title: Description of the incidence of thrombosis, bleeding, and mortality in the study population
         Item: 
          Title: Description of the univariate analysis
         Item: 
          Title: Proposed VTE predictive model and internal validation with bootstrapping
       Item: 
        Title: Discussion
       Item: 
        Title: Conclusion
       Item: 
        Title: Acknowledgments
       Item: 
        Title: References
   Info: 
    Title: Characterization of thrombosis risk in ambulatory patients with cancer: results of the observational, prospective, multicenter CARTAGO study
    Author: Javier Trujillo-Santos
    Subject: DOI: 10.1093/oncolo/oyae334
The Oncologist, Volume. 30, Issue. 8, 2 December 2024
Abstract 
Background:  Venous thromboembolism (VTE) is one of the leading causes of death in patients with cancer. Currently, there is a need to develop an easily applicable risk model that can identify patients who will benefit from receiving primary thromboprophylaxis to reduce the incidence of VTE.
Patients and methods:  This was a non-interventional, multicenter, observational, prospective study carried out in 62 Oncology and Hematology services in Spain and Portugal between January 2018 and December 2019. The main objective of the CARTAGO study was to develop a predictive model within a competitive risk framework to assess the risk of VTE in patients with cancer undergoing chemotherapy, biological, or hormonal treatment.
Results:  A total of 1596 patients were analyzed. VTE events occurred in 124 (8%) during the 6-month follow-up period (42% of deep vein thrombosis [DVT], 48% of pulmonary embolism [PE], and 10% of both DVT and PE). Four variables were selected for the multivariate predictive model to determine the risk of VTE (tumor type, D-dimer, compression of a vessel by the tumor, and leukocyte count). The 4 variables were associated with an increased risk of VTE (C-statistic, 0.646 [95%CI, 0.620-0.673]). The most significant variables in the internal validation with bootstrapping were the "very high risk" tumors (hazard ratio [HR] 2.032; 95%CI, 1.287-3.211).
Conclusion:  The CARTAGO model predicts the VTE risk in patients with cancer receiving anticancer therapy in an outpatient setting. This model can easily aid in identifying ambulatory patients who would probably benefit from primary thromboprophylaxis.
    Creator: Adobe InDesign 15.1 (Windows)
    Producer: Adobe PDF Library 15.0
    CreationDate: Fri Aug 29 07:58:22 CEST 2025
    ModDate: Fri Aug 29 07:59:52 CEST 2025
   ID: 0xb0536d1aa397234db1e7786e0acf095c, 0xd66d9eb4d5e4ec48bfe6e2d8a87fef3d
   Filters: 
    FilterPipeline: FlateDecode
    FilterPipeline: DCTDecode
   Images: 
    Image: 
     NisoImageMetadata: 
      FormatName: image/png
      ImageWidth: 1074
      ImageHeight: 795
      ColorSpace: CMYK
      BitsPerSample: 8
      BitsPerSampleUnit: integer
     Filter: FlateDecode
     Intent: RelativeColorimetric
     Name: X
    Image: 
     NisoImageMetadata: 
      FormatName: image/jpg
      CompressionScheme: JPEG
      ImageWidth: 1107
      ImageHeight: 1225
      ColorSpace: CMYK
      BitsPerSample: 8
      BitsPerSampleUnit: integer
     Intent: RelativeColorimetric
     Name: X
   Fonts: 
    Type1: 
     Font: 
      BaseFont: XYUAOE+UniversLTStd-Cn
      FontSubset: true
      FirstChar: 32
      LastChar: 250
      FontDescriptor: 
       FontName: XYUAOE+UniversLTStd-Cn
       Flags: Nonsymbolic
       FontBBox: -166, -250, 1000, 989
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: ADCIEY+UniversLTStd-BoldCn
      FontSubset: true
      FirstChar: 32
      LastChar: 121
      FontDescriptor: 
       FontName: ADCIEY+UniversLTStd-BoldCn
       Flags: Nonsymbolic
       FontBBox: -83, -250, 1000, 969
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: UCDYYK+UniversLTStd-Bold
      FontSubset: true
      FirstChar: 31
      LastChar: 250
      FontDescriptor: 
       FontName: UCDYYK+UniversLTStd-Bold
       Flags: Nonsymbolic
       FontBBox: -167, -250, 995, 938
       FontFile3: true
      EncodingDictionary: 
       BaseEncoding: WinAnsiEncoding
       Differences: true
      ToUnicode: true
     Font: 
      BaseFont: ZCMXQA+MyriadPro-Bold
      FontSubset: true
      FirstChar: 32
      LastChar: 42
      FontDescriptor: 
       FontName: ZCMXQA+MyriadPro-Bold
       Flags: Nonsymbolic
       FontBBox: -163, -250, 1256, 989
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: AIIZZY+SabonLTStd-Bold
      FontSubset: true
      FirstChar: 32
      LastChar: 121
      FontDescriptor: 
       FontName: AIIZZY+SabonLTStd-Bold
       Flags: Serif, Nonsymbolic
       FontBBox: -163, -228, 1000, 968
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: OGFANW+SabonLTStd-BoldItalic
      FontSubset: true
      FirstChar: 32
      LastChar: 80
      FontDescriptor: 
       FontName: OGFANW+SabonLTStd-BoldItalic
       Flags: Serif, Nonsymbolic, Italic
       FontBBox: -147, -238, 1080, 955
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: ZGZYQA+UniversLTStd
      FontSubset: true
      FirstChar: 32
      LastChar: 121
      FontDescriptor: 
       FontName: ZGZYQA+UniversLTStd
       Flags: Nonsymbolic
       FontBBox: -168, -250, 992, 947
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: RQLBIQ+MyriadPro-Regular
      FontSubset: true
      FirstChar: 32
      LastChar: 42
      FontDescriptor: 
       FontName: RQLBIQ+MyriadPro-Regular
       Flags: Nonsymbolic
       FontBBox: -157, -250, 1126, 952
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: KDZLOE+UniversLTStd-Light
      FontSubset: true
      FirstChar: 31
      LastChar: 148
      FontDescriptor: 
       FontName: KDZLOE+UniversLTStd-Light
       Flags: Nonsymbolic
       FontBBox: -151, -250, 1000, 957
       FontFile3: true
      EncodingDictionary: 
       BaseEncoding: WinAnsiEncoding
       Differences: true
      ToUnicode: true
     Font: 
      BaseFont: ZFGNQA+SabonLTStd-Roman
      FontSubset: true
      FirstChar: 28
      LastChar: 252
      FontDescriptor: 
       FontName: ZFGNQA+SabonLTStd-Roman
       Flags: Serif, Nonsymbolic
       FontBBox: -165, -228, 1000, 944
       FontFile3: true
      EncodingDictionary: 
       BaseEncoding: WinAnsiEncoding
       Differences: true
      ToUnicode: true
     Font: 
      BaseFont: OFMPSW+UniversLTStd-Obl
      FontSubset: true
      FirstChar: 32
      LastChar: 116
      FontDescriptor: 
       FontName: OFMPSW+UniversLTStd-Obl
       Flags: Nonsymbolic, Italic
       FontBBox: -174, -272, 1145, 947
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: ANMEEY+SabonLTStd-Italic
      FontSubset: true
      FirstChar: 32
      LastChar: 121
      FontDescriptor: 
       FontName: ANMEEY+SabonLTStd-Italic
       Flags: Serif, Nonsymbolic, Italic
       FontBBox: -146, -228, 1059, 927
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
     Font: 
      BaseFont: TKTCKM+UniversLTStd-CnObl
      FontSubset: true
      FirstChar: 32
      LastChar: 116
      FontDescriptor: 
       FontName: TKTCKM+UniversLTStd-CnObl
       Flags: Nonsymbolic, Italic
       FontBBox: -172, -270, 1064, 989
       FontFile3: true
      Encoding: WinAnsiEncoding
      ToUnicode: true
   XMP: <x:xmpmeta xmlns:x="adobe:ns:meta/" x:xmptk="Adobe XMP Core 9.1-c001 79.675d0f7, 2023/06/11-19:21:16        ">
   <rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#">
      <rdf:Description rdf:about=""
            xmlns:dc="http://purl.org/dc/elements/1.1/"
            xmlns:xmp="http://ns.adobe.com/xap/1.0/"
            xmlns:xmpMM="http://ns.adobe.com/xap/1.0/mm/"
            xmlns:stEvt="http://ns.adobe.com/xap/1.0/sType/ResourceEvent#"
            xmlns:stRef="http://ns.adobe.com/xap/1.0/sType/ResourceRef#"
            xmlns:xmpRights="http://ns.adobe.com/xap/1.0/rights/"
            xmlns:pdf="http://ns.adobe.com/pdf/1.3/"
            xmlns:pdfaid="http://www.aiim.org/pdfa/ns/id/"
            xmlns:pdfuaid="http://www.aiim.org/pdfua/ns/id/"
            xmlns:pdfaExtension="http://www.aiim.org/pdfa/ns/extension/"
            xmlns:pdfaSchema="http://www.aiim.org/pdfa/ns/schema#"
            xmlns:pdfaProperty="http://www.aiim.org/pdfa/ns/property#">
         <dc:format>application/pdf</dc:format>
         <dc:title>
            <rdf:Alt>
               <rdf:li xml:lang="x-default">Characterization of thrombosis risk in ambulatory patients with cancer: results of the observational, prospective, multicenter CARTAGO study</rdf:li>
            </rdf:Alt>
         </dc:title>
         <dc:description>
            <rdf:Alt>
               <rdf:li xml:lang="x-default">DOI: 10.1093/oncolo/oyae334&#xD;The Oncologist, Volume. 30, Issue. 8, 2 December 2024&#xD;Abstract &#xD;Background:  Venous thromboembolism (VTE) is one of the leading causes of death in patients with cancer. Currently, there is a need to develop an easily applicable risk model that can identify patients who will benefit from receiving primary thromboprophylaxis to reduce the incidence of VTE.&#xD;Patients and methods:  This was a non-interventional, multicenter, observational, prospective study carried out in 62 Oncology and Hematology services in Spain and Portugal between January 2018 and December 2019. The main objective of the CARTAGO study was to develop a predictive model within a competitive risk framework to assess the risk of VTE in patients with cancer undergoing chemotherapy, biological, or hormonal treatment.&#xD;Results:  A total of 1596 patients were analyzed. VTE events occurred in 124 (8%) during the 6-month follow-up period (42% of deep vein thrombosis [DVT], 48% of pulmonary embolism [PE], and 10% of both DVT and PE). Four variables were selected for the multivariate predictive model to determine the risk of VTE (tumor type, D-dimer, compression of a vessel by the tumor, and leukocyte count). The 4 variables were associated with an increased risk of VTE (C-statistic, 0.646 [95%CI, 0.620-0.673]). The most significant variables in the internal validation with bootstrapping were the "very high risk" tumors (hazard ratio [HR] 2.032; 95%CI, 1.287-3.211).&#xD;Conclusion:  The CARTAGO model predicts the VTE risk in patients with cancer receiving anticancer therapy in an outpatient setting. This model can easily aid in identifying ambulatory patients who would probably benefit from primary thromboprophylaxis.</rdf:li>
            </rdf:Alt>
         </dc:description>
         <dc:rights>
            <rdf:Alt>
               <rdf:li xml:lang="x-default">© The Author(s) 2024. Published by Oxford University Press.</rdf:li>
            </rdf:Alt>
         </dc:rights>
         <dc:creator>
            <rdf:Seq>
               <rdf:li>Javier Trujillo-Santos</rdf:li>
               <rdf:li> Ignacio García-Escobar</rdf:li>
               <rdf:li> Mercedes Salgado</rdf:li>
               <rdf:li> António Araújo</rdf:li>
               <rdf:li> Eva Martínez-de-Castro</rdf:li>
               <rdf:li> Raquel Molina</rdf:li>
               <rdf:li> Victoria E Castellón-Rubio</rdf:li>
               <rdf:li> Pere Domènech</rdf:li>
               <rdf:li> Enrique Gallardo</rdf:li>
               <rdf:li> Esteve Colomé</rdf:li>
               <rdf:li> Ferran Torres</rdf:li>
               <rdf:li> José-Carlos Benítez-Montañez</rdf:li>
               <rdf:li> Rut Porta</rdf:li>
               <rdf:li> Míriam Lobo-de-Mena</rdf:li>
               <rdf:li> Mariana Malheiro</rdf:li>
               <rdf:li> Carme Font</rdf:li>
               <rdf:li> Elena Brozos-Vázquez</rdf:li>
               <rdf:li> Fernando Garicano</rdf:li>
               <rdf:li> Víctor Sapena</rdf:li>
               <rdf:li> Ana-Lucia Costa</rdf:li>
               <rdf:li> Ana-Cristina Albuquerque</rdf:li>
               <rdf:li> Pablo Cerezuela</rdf:li>
               <rdf:li> Sara  Agraso </rdf:li>
               <rdf:li> Georgia  Anguera </rdf:li>
               <rdf:li> Maite  Antonio </rdf:li>
               <rdf:li> David  Arias </rdf:li>
               <rdf:li> Mercedes  Biosca </rdf:li>
               <rdf:li> Ana  Blasco </rdf:li>
               <rdf:li> Anna  Bustins </rdf:li>
               <rdf:li> Diego  Cacho </rdf:li>
               <rdf:li> Núria  Calvo </rdf:li>
               <rdf:li> Begoña  Campos-Balea </rdf:li>
               <rdf:li> Marta  Carmona </rdf:li>
               <rdf:li> Elena  Cillan </rdf:li>
               <rdf:li> Carmen  Díaz-Pedroche </rdf:li>
               <rdf:li> Paula  Espinosa Olarte </rdf:li>
               <rdf:li> Francis  Exposito </rdf:li>
               <rdf:li> Isaura  Fernández </rdf:li>
               <rdf:li> Lourdes  Fernández-Franco </rdf:li>
               <rdf:li> Tomeu  Fullana </rdf:li>
               <rdf:li> Silvia  García-Adrián </rdf:li>
               <rdf:li> Javier  García-Sánchez </rdf:li>
               <rdf:li> Sandra  Giménez </rdf:li>
               <rdf:li> Irene  González-Cebrián </rdf:li>
               <rdf:li> Manuel  González Moya </rdf:li>
               <rdf:li> Clara  Lucía Gozálvez </rdf:li>
               <rdf:li> David  Gutiérrez-Abad </rdf:li>
               <rdf:li> Yolanda  Lage </rdf:li>
               <rdf:li> Rosa  López </rdf:li>
               <rdf:li> María  Luisa Limón </rdf:li>
               <rdf:li> Raquel  Luque </rdf:li>
               <rdf:li> Agustín  Hernández </rdf:li>
               <rdf:li> Evelin  Horvath </rdf:li>
               <rdf:li> Rosa  López </rdf:li>
               <rdf:li> Ismael  Macias </rdf:li>
               <rdf:li> Montse  Mangas </rdf:li>
               <rdf:li> Pascual  Marco </rdf:li>
               <rdf:li> Edelmira  Martí </rdf:li>
               <rdf:li> Purificación  Martínez-del-Prado </rdf:li>
               <rdf:li> Maria  Masvidal </rdf:li>
               <rdf:li> Marina  Meri </rdf:li>
               <rdf:li> Marta  Merino </rdf:li>
               <rdf:li> Yolanda  de Miguel </rdf:li>
               <rdf:li> Santiago  Moragon </rdf:li>
               <rdf:li> Daniela  Morello </rdf:li>
               <rdf:li> Berta  Obispo </rdf:li>
               <rdf:li> Montse  Pàmpols </rdf:li>
               <rdf:li> Pedro  Pérez-Segura </rdf:li>
               <rdf:li> Beatriz  Rivas </rdf:li>
               <rdf:li> Alberto  Rodrigo </rdf:li>
               <rdf:li> Silverio  Ros </rdf:li>
               <rdf:li> Araceli  Sabino-Álvarez </rdf:li>
               <rdf:li> Diego  Salgado </rdf:li>
               <rdf:li> Raúl  Sánchez </rdf:li>
               <rdf:li> Lucía  Teijeira </rdf:li>
               <rdf:li> María  Valero-Arbizu </rdf:li>
               <rdf:li> Francisca  Vazquez </rdf:li>
               <rdf:li> Jose Carlos Villa </rdf:li>
               <rdf:li> Paula  Alves </rdf:li>
               <rdf:li> Júlia  Amorim </rdf:li>
               <rdf:li> Anabela  Barros </rdf:li>
               <rdf:li> Carolina  Carvalho </rdf:li>
               <rdf:li> Nuno  Couto </rdf:li>
               <rdf:li> Ana  Rita Garcia </rdf:li>
               <rdf:li> Vitória  Gemas </rdf:li>
               <rdf:li> Beatriz  Gosalbez </rdf:li>
               <rdf:li> Hélder  Mansinho </rdf:li>
               <rdf:li> Jorge  Martinez </rdf:li>
               <rdf:li> Mafalda  Peres </rdf:li>
               <rdf:li> António  Moreira Pinto </rdf:li>
               <rdf:li> Catarina  Pulido </rdf:li>
               <rdf:li> Ana  Raimundo </rdf:li>
               <rdf:li> Maria João Ribeiro </rdf:li>
            </rdf:Seq>
         </dc:creator>
         <dc:subject>
            <rdf:Bag>
               <rdf:li>D-dimer </rdf:li>
               <rdf:li>leukocytes </rdf:li>
               <rdf:li>thromboprophylaxis </rdf:li>
               <rdf:li>venous thromboembolism </rdf:li>
               <rdf:li>cancer.</rdf:li>
            </rdf:Bag>
         </dc:subject>
         <xmp:CreateDate>2025-08-29T10:58:22+05:30</xmp:CreateDate>
         <xmp:CreatorTool>Adobe InDesign 15.1 (Windows)</xmp:CreatorTool>
         <xmp:ModifyDate>2025-08-29T10:59:52+05:30</xmp:ModifyDate>
         <xmp:MetadataDate>2025-08-29T10:59:52+05:30</xmp:MetadataDate>
         <xmpMM:InstanceID>uuid:535440a2-3f8b-4b5e-ae77-bd101e19b050</xmpMM:InstanceID>
         <xmpMM:OriginalDocumentID>xmp.did:62536b05-d23c-e441-8b83-3cf623a2daf6</xmpMM:OriginalDocumentID>
         <xmpMM:DocumentID>xmp.id:95fb7a63-7541-4045-98ce-628e022bf1c4</xmpMM:DocumentID>
         <xmpMM:RenditionClass>proof:pdf</xmpMM:RenditionClass>
         <xmpMM:VersionID>1</xmpMM:VersionID>
         <xmpMM:History>
            <rdf:Seq>
               <rdf:li rdf:parseType="Resource">
                  <stEvt:action>converted</stEvt:action>
                  <stEvt:parameters>from application/x-indesign to application/pdf</stEvt:parameters>
                  <stEvt:softwareAgent>Adobe InDesign 15.1 (Windows)</stEvt:softwareAgent>
                  <stEvt:when>2025-08-29T10:58:22+05:30</stEvt:when>
               </rdf:li>
               <rdf:li rdf:parseType="Resource">
                  <stEvt:action>converted</stEvt:action>
                  <stEvt:instanceID>uuid:75a11c52-29d5-4c6b-a364-e5f54fa3f48e</stEvt:instanceID>
                  <stEvt:parameters>converted to PDF/A-3a</stEvt:parameters>
                  <stEvt:softwareAgent>Preflight</stEvt:softwareAgent>
                  <stEvt:when>2025-08-29T10:59:46+05:30</stEvt:when>
               </rdf:li>
            </rdf:Seq>
         </xmpMM:History>
         <xmpMM:DerivedFrom rdf:parseType="Resource">
            <stRef:instanceID>xmp.iid:a162c1df-3c93-bb41-8da6-22fe2856d520</stRef:instanceID>
            <stRef:documentID>xmp.did:8f10b307-6bae-1e4a-bd87-6a613cd9216a</stRef:documentID>
            <stRef:renditionClass>default</stRef:renditionClass>
         </xmpMM:DerivedFrom>
         <xmpRights:Marked>True</xmpRights:Marked>
         <pdf:Producer>Adobe PDF Library 15.0</pdf:Producer>
         <pdf:Trapped>False</pdf:Trapped>
         <pdfaid:part>3</pdfaid:part>
         <pdfaid:conformance>A</pdfaid:conformance>
         <pdfuaid:part>1</pdfuaid:part>
         <pdfaExtension:schemas>
            <rdf:Bag>
               <rdf:li rdf:parseType="Resource">
                  <pdfaSchema:namespaceURI>http://ns.adobe.com/xap/1.0/mm/</pdfaSchema:namespaceURI>
                  <pdfaSchema:prefix>xmpMM</pdfaSchema:prefix>
                  <pdfaSchema:schema>XMP Media Management Schema</pdfaSchema:schema>
                  <pdfaSchema:property>
                     <rdf:Seq>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>UUID based identifier for specific incarnation of a document</pdfaProperty:description>
                           <pdfaProperty:name>InstanceID</pdfaProperty:name>
                           <pdfaProperty:valueType>URI</pdfaProperty:valueType>
                        </rdf:li>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>The common identifier for all versions and renditions of a document.</pdfaProperty:description>
                           <pdfaProperty:name>OriginalDocumentID</pdfaProperty:name>
                           <pdfaProperty:valueType>URI</pdfaProperty:valueType>
                        </rdf:li>
                     </rdf:Seq>
                  </pdfaSchema:property>
               </rdf:li>
               <rdf:li rdf:parseType="Resource">
                  <pdfaSchema:namespaceURI>http://ns.adobe.com/pdf/1.3/</pdfaSchema:namespaceURI>
                  <pdfaSchema:prefix>pdf</pdfaSchema:prefix>
                  <pdfaSchema:schema>Adobe PDF Schema</pdfaSchema:schema>
                  <pdfaSchema:property>
                     <rdf:Seq>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>A name object indicating whether the document has been modified to include trapping information</pdfaProperty:description>
                           <pdfaProperty:name>Trapped</pdfaProperty:name>
                           <pdfaProperty:valueType>Text</pdfaProperty:valueType>
                        </rdf:li>
                     </rdf:Seq>
                  </pdfaSchema:property>
               </rdf:li>
               <rdf:li rdf:parseType="Resource">
                  <pdfaSchema:namespaceURI>http://www.aiim.org/pdfa/ns/id/</pdfaSchema:namespaceURI>
                  <pdfaSchema:prefix>pdfaid</pdfaSchema:prefix>
                  <pdfaSchema:schema>PDF/A ID Schema</pdfaSchema:schema>
                  <pdfaSchema:property>
                     <rdf:Seq>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>Part of PDF/A standard</pdfaProperty:description>
                           <pdfaProperty:name>part</pdfaProperty:name>
                           <pdfaProperty:valueType>Integer</pdfaProperty:valueType>
                        </rdf:li>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>Amendment of PDF/A standard</pdfaProperty:description>
                           <pdfaProperty:name>amd</pdfaProperty:name>
                           <pdfaProperty:valueType>Text</pdfaProperty:valueType>
                        </rdf:li>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>Conformance level of PDF/A standard</pdfaProperty:description>
                           <pdfaProperty:name>conformance</pdfaProperty:name>
                           <pdfaProperty:valueType>Text</pdfaProperty:valueType>
                        </rdf:li>
                     </rdf:Seq>
                  </pdfaSchema:property>
               </rdf:li>
               <rdf:li rdf:parseType="Resource">
                  <pdfaSchema:namespaceURI>http://www.aiim.org/pdfua/ns/id/</pdfaSchema:namespaceURI>
                  <pdfaSchema:prefix>pdfuaid</pdfaSchema:prefix>
                  <pdfaSchema:schema>PDF/UA ID Schema</pdfaSchema:schema>
                  <pdfaSchema:property>
                     <rdf:Seq>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>Part of PDF/UA standard</pdfaProperty:description>
                           <pdfaProperty:name>part</pdfaProperty:name>
                           <pdfaProperty:valueType>Integer</pdfaProperty:valueType>
                        </rdf:li>
                     </rdf:Seq>
                  </pdfaSchema:property>
               </rdf:li>
            </rdf:Bag>
         </pdfaExtension:schemas>
      </rdf:Description>
   </rdf:RDF>
</x:xmpmeta>
   Pages: 
    Page: 
     Sequence: 1
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 155, 599, 158, 586
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 160, 599, 163, 586
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 163, 601, 177, 587
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 301, 599, 304, 586
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 304, 601, 318, 587
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 418, 599, 421, 586
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 421, 601, 435, 587
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 517, 599, 521, 586
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 520, 601, 534, 587
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 170, 584, 173, 571
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 173, 586, 187, 572
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 266, 584, 270, 571
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 269, 586, 283, 572
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 422, 584, 425, 571
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 425, 586, 439, 572
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 524, 584, 528, 571
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 528, 586, 542, 572
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 135, 569, 139, 556
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 138, 571, 152, 557
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 234, 569, 241, 556
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 241, 571, 255, 557
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 324, 569, 330, 556
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 330, 571, 344, 557
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 507, 569, 514, 556
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 513, 571, 527, 557
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 97, 554, 104, 541
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 103, 556, 117, 542
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 237, 554, 244, 541
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 244, 556, 258, 542
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 353, 554, 360, 541
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 360, 556, 374, 542
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 438, 554, 446, 541
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 445, 556, 459, 542
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 162, 539, 169, 526
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 169, 541, 183, 527
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 285, 539, 292, 526
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 292, 541, 306, 527
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 382, 539, 389, 526
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 389, 541, 403, 527
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 491, 539, 498, 526
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 182, 524, 189, 511
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 278, 524, 285, 511
       Flags: Print
       AppearanceDictionary: true
       Destination: 2270
      Annotation: 
       Subtype: Link
       Rect: 285, 526, 299, 512
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 102, 265, 201, 255
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 388, 46, 531, 37
       Flags: Print
       AppearanceDictionary: true
    Page: 
     Sequence: 2
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 204, 603, 207, 592
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 223, 581, 226, 570
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 237, 526, 240, 515
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 241, 526, 244, 515
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 161, 504, 164, 493
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 282, 482, 285, 471
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 159, 438, 162, 427
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 164, 438, 167, 427
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 94, 306, 97, 295
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 196, 284, 199, 273
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 271, 251, 278, 240
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 279, 251, 285, 240
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 184, 218, 190, 207
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 74, 174, 80, 163
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 192, 119, 195, 108
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 347, 458, 353, 447
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 458, 359, 464, 348
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 488, 271, 494, 260
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
    Page: 
     Sequence: 3
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 205, 290, 211, 279
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 67, 279, 73, 268
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 175, 213, 181, 202
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 91, 147, 97, 136
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 392, 664, 425, 653
       Flags: Print
       AppearanceDictionary: true
       Destination: 5
      Annotation: 
       Subtype: Link
       Rect: 486, 642, 492, 631
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 519, 609, 525, 598
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 469, 454, 502, 443
       Flags: Print
       AppearanceDictionary: true
       Destination: 9
      Annotation: 
       Subtype: Link
       Rect: 521, 454, 550, 443
       Flags: Print
       AppearanceDictionary: true
       Destination: 13
      Annotation: 
       Subtype: Link
       Rect: 371, 223, 405, 212
       Flags: Print
       AppearanceDictionary: true
       Destination: 9
      Annotation: 
       Subtype: Link
       Rect: 319, 179, 349, 168
       Flags: Print
       AppearanceDictionary: true
       Destination: 13
      Annotation: 
       Subtype: Link
       Rect: 384, 179, 480, 168
       Flags: Print
       AppearanceDictionary: true
    Page: 
     Sequence: 4
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 315, 362, 347, 352
       Flags: Print
       AppearanceDictionary: true
       Destination: 15
      Annotation: 
       Subtype: Link
       Rect: 371, 362, 471, 352
       Flags: Print
       AppearanceDictionary: true
    Page: 
     Sequence: 5
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 209, 243, 240, 232
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 469, 210, 502, 199
       Flags: Print
       AppearanceDictionary: true
       Destination: 9
      Annotation: 
       Subtype: Link
       Rect: 309, 133, 415, 122
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 436, 133, 446, 122
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 321, 45, 425, 34
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 428, 45, 438, 34
       Flags: Print
       AppearanceDictionary: true
    Page: 
     Sequence: 6
    Page: 
     Sequence: 7
    Page: 
     Sequence: 8
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 225, 484, 285, 473
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 42, 473, 81, 462
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 101, 473, 111, 462
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 279, 407, 285, 396
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 196, 352, 202, 341
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 63, 319, 69, 308
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 70, 319, 76, 308
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 155, 242, 158, 231
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 240, 154, 246, 143
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 533, 264, 539, 253
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 541, 264, 547, 253
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 402, 176, 408, 165
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 376, 99, 382, 88
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 130, 675, 132, 665
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
    Page: 
     Sequence: 9
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 68, 664, 74, 653
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 222, 609, 228, 598
       Flags: Print
       AppearanceDictionary: true
       Destination: 24
      Annotation: 
       Subtype: Link
       Rect: 61, 576, 67, 565
       Flags: Print
       AppearanceDictionary: true
       Destination: 26
      Annotation: 
       Subtype: Link
       Rect: 90, 521, 191, 510
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 140, 301, 241, 290
       Flags: Print
       AppearanceDictionary: true
    Page: 
     Sequence: 10
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 317, 556, 412, 547
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 317, 536, 488, 527
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 526, 470, 517
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 415, 496, 535, 487
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 486, 482, 477
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 317, 456, 465, 447
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 446, 414, 437
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 509, 436, 547, 427
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 426, 449, 417
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 416, 492, 407
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 421, 386, 537, 377
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 376, 490, 367
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 464, 346, 547, 337
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 336, 403, 327
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 326, 437, 317
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 390, 316, 486, 307
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 460, 296, 547, 287
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 286, 389, 277
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 276, 430, 267
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 509, 266, 547, 257
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 256, 444, 247
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 246, 450, 237
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 441, 216, 547, 207
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 206, 379, 197
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 196, 480, 187
       Flags: Print
       AppearanceDictionary: true
       Destination: 22
      Annotation: 
       Subtype: Link
       Rect: 451, 176, 547, 167
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 166, 393, 157
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 156, 467, 147
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 523, 136, 547, 127
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 126, 444, 117
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 303, 116, 314, 107
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 317, 96, 487, 87
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 317, 66, 482, 57
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 317, 56, 510, 47
       Flags: Print
       AppearanceDictionary: true
       Destination: 1
    Page: 
     Sequence: 11
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 135, 719, 282, 710
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 709, 104, 700
       Flags: Print
       AppearanceDictionary: true
       Destination: 3
      Annotation: 
       Subtype: Link
       Rect: 188, 689, 291, 680
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 679, 128, 670
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 669, 293, 660
       Flags: Print
       AppearanceDictionary: true
       Destination: 3
      Annotation: 
       Subtype: Link
       Rect: 62, 659, 75, 650
       Flags: Print
       AppearanceDictionary: true
       Destination: 3
      Annotation: 
       Subtype: Link
       Rect: 254, 649, 291, 640
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 639, 182, 630
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 629, 161, 620
       Flags: Print
       AppearanceDictionary: true
       Destination: 3
      Annotation: 
       Subtype: Link
       Rect: 62, 609, 220, 600
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 599, 136, 590
       Flags: Print
       AppearanceDictionary: true
       Destination: 3
      Annotation: 
       Subtype: Link
       Rect: 135, 579, 250, 570
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 569, 252, 560
       Flags: Print
       AppearanceDictionary: true
       Destination: 3
      Annotation: 
       Subtype: Link
       Rect: 254, 559, 291, 550
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 549, 208, 540
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 539, 245, 530
       Flags: Print
       AppearanceDictionary: true
       Destination: 3
      Annotation: 
       Subtype: Link
       Rect: 142, 509, 261, 500
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 499, 291, 490
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 79, 469, 255, 460
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 459, 245, 450
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 62, 429, 210, 420
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 419, 261, 410
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 209, 399, 291, 390
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 62, 389, 156, 380
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 729, 454, 720
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 515, 699, 552, 690
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 689, 421, 680
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 679, 478, 670
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 356, 649, 519, 640
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 639, 494, 630
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 515, 609, 552, 600
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 599, 449, 590
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 589, 440, 580
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 372, 569, 515, 560
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 559, 485, 550
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 466, 529, 552, 520
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 519, 401, 510
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 509, 480, 500
       Flags: Print
       AppearanceDictionary: true
       Destination: 20
      Annotation: 
       Subtype: Link
       Rect: 397, 479, 513, 470
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 469, 489, 460
       Flags: Print
       AppearanceDictionary: true
       Destination: 22
      Annotation: 
       Subtype: Link
       Rect: 344, 429, 508, 420
       Flags: Print
       AppearanceDictionary: true
      Annotation: 
       Subtype: Link
       Rect: 323, 419, 507, 410
       Flags: Print
       AppearanceDictionary: true
       Destination: 22
      Annotation: 
       Subtype: Link
       Rect: 323, 389, 492, 380
       Flags: Print
       AppearanceDictionary: true
  Checksum: 598bdf56
   Type: CRC32
  Checksum: c5b1f7699f9a050cb64aefb21022bbf3
   Type: MD5
  Checksum: 4b3ca2886e1eb8ff2b9c8d162265489ade4b49db
   Type: SHA-1
  Checksum: 3bb03d3f6a2cb1390e67e2db8d41f98761cb98317c9a5a79348217f94816835d
   Type: SHA-256