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Form values and PDF mapping for testing purpose
{
 "firstname": "",
 "lastname": "",
 "gender": "",
 "birthdate": "",
 "nationality": "BE",
 "nationalNumber": "",
 "email": "",
 "newsletter": false,
 "inbox": false,
 "phone": "",
 "mobilePhone": "",
 "mobilePhoneNational": "",
 "mobilePhonePrefix": "",
 "street": "",
 "streetNumber": "",
 "streetNumberAddition": "",
 "zipCode": "",
 "city": "",
 "country": "BE",
 "iban": "",
 "bic": "",
 "reimbursementAccountAuth": false,
 "affiliationType": "",
 "belgianStatus": "",
 "belgianMutualityName": "",
 "dependentHolderName": "",
 "dependentHolderNationalNumber": "",
 "dependentSchoolName": "",
 "dependentSchoolAddress": "",
 "otherRegimeUntil": "",
 "otherRegimeName": "",
 "otherRegimeAddress": "",
 "foreignContinued": false,
 "foreignName": "",
 "foreignAddress": "",
 "maritalStatus": "",
 "partnerName": "",
 "dependents": [],
 "dependentsIncluded": false,
 "professionalStatus": "",
 "statusSince": "",
 "employerName": "",
 "employerAddress": "",
 "unemploymentFundName": "",
 "unemploymentFundAddress": "",
 "incapacityOtherStatus": "",
 "selfEmployedType": "",
 "socialInsuranceFundName": "",
 "socialInsuranceFundAddress": "",
 "hospitalisationInterest": "",
 "hospitalisationNoReason": "",
 "hospInsuranceName": "",
 "hospiKontinuiteOptIn": false,
 "roomType": "",
 "feeSupplementLevel": "",
 "careGuaranteePeriod": "",
 "seriousIllnessInsurance": "",
 "dentalInterest": "",
 "dentalNoReason": "",
 "denInsuranceName": "",
 "dentaliaUpOptIn": false,
 "currentHospInsurance": false,
 "currentHospInsuranceName": "",
 "currentMedInsurance": false,
 "currentMedInsuranceName": "",
 "currentDentalInsurance": false,
 "currentDenInsuranceName": "",
 "selectedOffers": [],
 "pdfValues": {
  "date": "3/28/2026",
  "name": "",
  "firstname": "",
  "nrn": "",
  "nationality": "BE",
  "gender": "",
  "birthdate0": "",
  "street": "",
  "number": "",
  "postBoxNumber": "",
  "zipCode": "",
  "city": "",
  "countryDescription": "BE",
  "phone": "",
  "gsm": "",
  "email": "",
  "newsletter": "no",
  "inbox": "no",
  "currenmutualNumber": "",
  "mutuality": "mutuality",
  "insurance": "",
  "belgian": "",
  "iban": "",
  "bic": "",
  "kontonr": "no",
  "officialLanguage": "",
  "pacs": "no",
  "jobDate": "",
  "employee": "",
  "employername": "",
  "employeradress": "",
  "independant": "",
  "socialinsurancefond": "",
  "socialdondaddress": "",
  "status": "",
  "titularName": "",
  "titularNrn": "",
  "stillForeign": "",
  "foreignmutualName": "",
  "foreignmutualaddress": "",
  "school": "",
  "schoolName": "",
  "schooladdress": "",
  "SNCB": "",
  "SNCB/UE": "",
  "othermutualdate": "",
  "othermutual": "",
  "othermutualaddress": "",
  "hospital1": "",
  "hospinsuranceName": "",
  "room": "",
  "honoraire": "",
  "sickness": "",
  "dental1": "",
  "deninsuranceName": "",
  "hospital2": "",
  "medical2": "",
  "medinsuranceName": "",
  "dental2": "",
  "hospiKont": "no",
  "hospiCare": "no",
  "hospiPlus": "no",
  "hospiSmart": "no",
  "maladieGrave": "no",
  "dentaliaUp": "no"
 }
}
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