1 => [ [50, 26, "Ins Company Name"    , ""]],
2 => [ [50, 26, "Ins Street Address"  , ""]],
3 => [ [50, 26, "Ins Street Address 2", ""]],
4 => [ [50, 12, "Ins City" ,""],
       [64,  2, "Ins State",""],
       [67,  5, "Ins Zip"  ,""], ],
6 => [ [57, 22, "Unknown", ""]],
8 => [ [ 1,  1, "Medicare" ,"" , '1'],
       [ 8,  1, "Medicade" ,"" , '1'],
       [15,  1, "Champus"  ,"" , '1'],
       [24,  1, "Champva"  ,"" , '1'],
       [31,  1, "Group Health Plan"  ,"" , '1'],
       [39,  1, "FECA BLK LUNG"      ,"" , '1'],
       [45,  1, "Other"    ,"" , '1'],
       [50, 17, "Insured's I.D. Number"    ,"" , '1a'],  ],

##</code><code>##

my $hcfa = do "hcfa.lay";

my $layout = [];
foreach my $line ( sort keys %$hcfa ) {
        foreach my $item ( @{$hcfa->{$line}} ) {
                insert_into_layout($layout, $line, $item->[0], "X" x $item->[1]);
        }
}
print layout_form($layout);


sub insert_into_layout {
    my ($layout, $line, $row, $value) = @_;
    my @data = split //, $value;
    my $offset = 0;
    foreach ( @data ) {
            $layout->[$line][$row + $offset++] = $_;
    }
}

sub layout_form {
    my $layout = shift;
    my $output;
    foreach my $row (@$layout) {
            foreach my $val (@$row) {
                    $output .= (defined $val ? $val : ' ');
            }
            $output .= "\n";
    }
    return $output;
}