Unnamed2
DataAmendedText
text
DataAmendedDate
date
On Treatment
TreatmentEvaluationPeriodType
text
Off Treatment
PersonOff-TreatmentTimePeriodType
text
Unnamed4
AdverseEventCurrentAssessmentInd
text
CTCAdverseEventReportBeginDate
date
CTCAdverseEventReportEndDate
date
Unnamed5
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermName
text
AdverseEventSeverityGrade
text
CTCAdverseEventAttributionScale
text
AdverseEventInvestigationalClinicalStudyTherapyAttributionind-2
text
AdverseDrugExperienceReportText
text
ImmuneSystemAdverseEventPresentText
text
Unnamed6
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermName
text
AdverseEventSeverityGrade
text
CTCAdverseEventAttributionScale
text
AdverseEventInvestigationalClinicalStudyTherapyAttributionind-2
text
AdverseDrugExperienceReportText
text
ImmuneSystemAdverseEventPresentText
text
Other Adverse Events
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermName
text
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermOtherSpecifyText
text
AdverseEventSeverityGrade
text
CTCAdverseEventAttributionScale
text
AdverseEventInvestigationalClinicalStudyTherapyAttributionind-2
text
AdverseDrugExperienceReportText
text
ImmuneSystemAdverseEventPresentText
text
Comments
InvestigatorSignatureText
text
InvestigatorSignatureDate
date