ID

17695

Description

Hospital Routine Documentation Form at the University Hospital Muenster. Original Form name: Aerztl AZ Berufskrankheit - composer.

Keywords

Versions (2)
  1. 9/28/16 9/28/16 -
  2. 9/28/16 9/28/16 -
Uploaded on

September 28, 2016

DOI

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License

Creative Commons BY-NC 3.0
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Medical Notification Occupational Disease University Hospital Muenster (UKM)

German English

Medical Notification Occupational Disease University Hospital Muenster (UKM)

1 forms  
Default Itemgroup
Description

Default Itemgroup

Alias
UMLS CUI-1
C0422202
UMLS CUI-2
C0028797
membership number
Description

membership number

Data type

text

Alias
UMLS CUI [1]
C1548070
trade control
Description

trade control

Data type

text

road number job center
Description

road number job center

Data type

text

type of accident
Description

type of accident

Data type

text

Alias
UMLS CUI [1,1]
C0000924
UMLS CUI [1,2]
C0332307
registration type
Description

registration type

Data type

text

registration year
Description

registration year

Data type

integer

Alias
UMLS CUI [1,1]
C1514821
UMLS CUI [1,2]
C0439234
insurance carrier
Description

insurance carrier

Data type

text

Alias
UMLS CUI [1]
C0021675
assurance product
Description

assurance product

Data type

text

Alias
UMLS CUI [1]
C0021680
file reference
Description

file reference

Data type

text

address
Description

address

Data type

text

Alias
UMLS CUI [1]
C0376649
Information about Insurant
Description

Information about Insurant

patient name
Description

patient name

Data type

text

Alias
UMLS CUI [1]
C1299487
insurance numbers or birth date
Description

insurance numbers or birth date

Data type

text

Alias
UMLS CUI [1]
C0421451
UMLS CUI [2,1]
C0021680
UMLS CUI [2,2]
C0600091
street
Description

street

Data type

text

Alias
UMLS CUI [1]
C1301826
PLZ
Description

PLZ

Data type

text

Alias
UMLS CUI [1]
C0421454
city
Description

city

Data type

text

Alias
UMLS CUI [1]
C0008848
comment 7
Description

comment 7

Data type

text

gender
Description

gender

Data type

text

Alias
UMLS CUI [1]
C0079399
nationality
Description

nationality

Data type

text

Alias
UMLS CUI [1]
C0027473
comment 9
Description

comment 9

Data type

text

comment 10
Description

comment 10

Data type

text

workplace
Description

workplace

Data type

text

Alias
UMLS CUI [1]
C0162579
occupation
Description

occupation

Data type

text

Alias
UMLS CUI [1]
C0028811
occupation since
Description

occupation since

Data type

text

Alias
UMLS CUI [1,1]
C0028811
UMLS CUI [1,2]
C0946385
health insurance
Description

health insurance

Data type

text

Alias
UMLS CUI [1]
C0021682
stopped working
Description

stopped working

Data type

boolean

Alias
UMLS CUI [1]
C0425082
date stopped work
Description

date stopped work

Data type

text

Alias
UMLS CUI [1,1]
C0425082
UMLS CUI [1,2]
C0011008
returned to work
Description

returned to work

Data type

boolean

Alias
UMLS CUI [1]
C0425105
returned to work date
Description

returned to work date

Data type

text

Alias
UMLS CUI [1,1]
C0425105
UMLS CUI [1,2]
C0011008
Information about Health State of Patient
Description

Information about Health State of Patient

complaints
Description

complaints

Data type

text

Alias
UMLS CUI [1]
C0871764
onset complaints
Description

onset complaints

Data type

text

Alias
UMLS CUI [1,1]
C0871764
UMLS CUI [1,2]
C0332162
occupational impacts
Description

occupational impacts

Data type

text

Alias
UMLS CUI [1]
C3539941
occupational disease
Description

occupational disease

Data type

text

Alias
UMLS CUI [1]
C0028797
comment 25
Description

comment 25

Data type

text

diagnosis
Description

diagnosis

Data type

text

Alias
UMLS CUI [1]
C0497120
UMLS CUI [2]
C0011900
pre-existing conditions
Description

pre-existing conditions

Data type

text

Alias
UMLS CUI [1]
C0521987
physican
Description

physican

Data type

text

Alias
UMLS CUI [1,1]
C0031831
UMLS CUI [1,2]
C0087111
UMLS CUI [1,3]
C0205435
current physician
Description

current physician

Data type

text

Alias
UMLS CUI [1,1]
C0031831
UMLS CUI [1,2]
C0087111
UMLS CUI [1,3]
C0521116
insurant current place
Description

insurant current place

Data type

text

Alias
UMLS CUI [1,1]
C0442504
UMLS CUI [1,2]
C0030705
treatments
Description

treatments

Data type

text

Alias
UMLS CUI [1]
C0087111
treatment date
Description

treatment date

Data type

date

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C0011008
no treatment
Description

no treatment

Data type

boolean

Alias
UMLS CUI [1]
C0746919
death of patient
Description

death of patient

Data type

boolean

Alias
UMLS CUI [1]
C0011065
time of death
Description

time of death

Data type

datetime

Alias
UMLS CUI [1]
C1301931
comment 33
Description

comment 33

Data type

text

autopsy
Description

autopsy

Data type

boolean

Alias
UMLS CUI [1]
C0004398
time autopsy
Description

time autopsy

Data type

date

Alias
UMLS CUI [1,1]
C0004398
UMLS CUI [1,2]
C0011008
autopsy performer
Description

autopsy performer

Data type

text

Alias
UMLS CUI [1,1]
C0004398
UMLS CUI [1,2]
C0027361
Information about Occupation of Patient
Description

Information about Occupation of Patient

name and type of company
Description

name and type of company

Data type

text

Alias
UMLS CUI [1]
C0683757
PLZ company
Description

PLZ company

Data type

text

Alias
UMLS CUI [1,1]
C0683757
UMLS CUI [1,2]
C1514254
city and street
Description

city and street

Data type

text

Alias
UMLS CUI [1,1]
C0683757
UMLS CUI [1,2]
C1442065
occupation
Description

occupation

Data type

text

Alias
UMLS CUI [1]
C0028811
occupation date
Description

occupation date

Data type

date

Alias
UMLS CUI [1,1]
C0028811
UMLS CUI [1,2]
C0011008
occupation duration
Description

occupation duration

Data type

text

Alias
UMLS CUI [1,1]
C0028811
UMLS CUI [1,2]
C0449238
occupational medicine check-ups
Description

occupational medicine check-ups

Data type

text

Alias
UMLS CUI [1,1]
C1555855
UMLS CUI [1,2]
C0598836
additional information
Description

additional information

Data type

text

Alias
UMLS CUI [1]
C1546922
place and date
Description

place and date

Data type

text

Alias
UMLS CUI [1]
C0011008
address
Description

address

Data type

text

Alias
UMLS CUI [1]
C0421449
financial institute
Description

financial institute

Data type

text

Alias
UMLS CUI [1]
C0442598
bank account number
Description

bank account number

Data type

text

Alias
UMLS CUI [1]
C1549682
BIC
Description

BIC

Data type

text

Alias
UMLS CUI [1]
C1549682
signature physician
Description

signature physician

Data type

text

Alias
UMLS CUI [1]
C0807938
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Similar models

Medical Notification Occupational Disease University Hospital Muenster (UKM)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Default Itemgroup
C0422202 (UMLS CUI-1)
C0028797 (UMLS CUI-2)
membership number
Item
text
C1548070 (UMLS CUI [1])
trade control
Item
text
road number job center
Item
text
type of accident
Item
text
C0000924 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
registration type
Item
text
registration year
Item
integer
C1514821 (UMLS CUI [1,1])
C0439234 (UMLS CUI [1,2])
insurance carrier
Item
text
C0021675 (UMLS CUI [1])
assurance product
Item
text
C0021680 (UMLS CUI [1])
file reference
Item
text
address
Item
text
C0376649 (UMLS CUI [1])
patient name
Item
text
C1299487 (UMLS CUI [1])
insurance numbers or birth date
Item
text
C0421451 (UMLS CUI [1])
C0021680 (UMLS CUI [2,1])
C0600091 (UMLS CUI [2,2])
street
Item
text
C1301826 (UMLS CUI [1])
PLZ
Item
text
C0421454 (UMLS CUI [1])
city
Item
text
C0008848 (UMLS CUI [1])
comment 7
Item
text
Item
text
C0079399 (UMLS CUI [1])
gender
Code List
gender
CL Item
 (männlich)
CL Item
 (weiblich)
nationality
Item
text
C0027473 (UMLS CUI [1])
comment 9
Item
text
comment 10
Item
text
workplace
Item
text
C0162579 (UMLS CUI [1])
occupation
Item
text
C0028811 (UMLS CUI [1])
occupation since
Item
text
C0028811 (UMLS CUI [1,1])
C0946385 (UMLS CUI [1,2])
health insurance
Item
text
C0021682 (UMLS CUI [1])
stopped working
Item
boolean
C0425082 (UMLS CUI [1])
date stopped work
Item
text
C0425082 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
returned to work
Item
boolean
C0425105 (UMLS CUI [1])
returned to work date
Item
text
C0425105 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
complaints
Item
text
C0871764 (UMLS CUI [1])
onset complaints
Item
text
C0871764 (UMLS CUI [1,1])
C0332162 (UMLS CUI [1,2])
occupational impacts
Item
text
C3539941 (UMLS CUI [1])
occupational disease
Item
text
C0028797 (UMLS CUI [1])
comment 25
Item
text
diagnosis
Item
text
C0497120 (UMLS CUI [1])
C0011900 (UMLS CUI [2])
pre-existing conditions
Item
text
C0521987 (UMLS CUI [1])
physican
Item
text
C0031831 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0205435 (UMLS CUI [1,3])
current physician
Item
text
C0031831 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0521116 (UMLS CUI [1,3])
insurant current place
Item
text
C0442504 (UMLS CUI [1,1])
C0030705 (UMLS CUI [1,2])
treatments
Item
text
C0087111 (UMLS CUI [1])
treatment date
Item
date
C0087111 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
no treatment
Item
boolean
C0746919 (UMLS CUI [1])
death of patient
Item
boolean
C0011065 (UMLS CUI [1])
time of death
Item
datetime
C1301931 (UMLS CUI [1])
comment 33
Item
text
autopsy
Item
boolean
C0004398 (UMLS CUI [1])
time autopsy
Item
date
C0004398 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
autopsy performer
Item
text
C0004398 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
name and type of company
Item
text
C0683757 (UMLS CUI [1])
PLZ company
Item
text
C0683757 (UMLS CUI [1,1])
C1514254 (UMLS CUI [1,2])
city and street
Item
text
C0683757 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
occupation
Item
text
C0028811 (UMLS CUI [1])
occupation date
Item
date
C0028811 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
occupation duration
Item
text
C0028811 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
occupational medicine check-ups
Item
text
C1555855 (UMLS CUI [1,1])
C0598836 (UMLS CUI [1,2])
additional information
Item
text
C1546922 (UMLS CUI [1])
place and date
Item
text
C0011008 (UMLS CUI [1])
address
Item
text
C0421449 (UMLS CUI [1])
financial institute
Item
text
C0442598 (UMLS CUI [1])
bank account number
Item
text
C1549682 (UMLS CUI [1])
BIC
Item
text
C1549682 (UMLS CUI [1])
signature physician
Item
text
C0807938 (UMLS CUI [1])
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