Inglés

Unscheduled Visit Study Drug: Accountability - Unscheduled [DA_1E] NCT01117584

1 formularios  
General Information
Descripción

General Information

If subject lost or misplaced study drug, indicate replacement information below.
Descripción

Subject lost or misplaced

Tipo de datos

text

Dispensed Date
Descripción

Dispensed Date

Tipo de datos

date

Replacement Kit Number
Descripción

Replacement Kit Number

Tipo de datos

text

No. of Capsules/Tablets dispensed
Descripción

No. of Capsules/Tablets dispensed

Tipo de datos

float

Were any of the wallets within the kit returned?
Descripción

Any Containers Returned

Tipo de datos

boolean

Returned Date
Descripción

Returned Date

Tipo de datos

date

No. of Capsules/Tablets returned
Descripción

No. of Capsules/Tablets returned

Tipo de datos

float

Comment
Descripción

Comment

Tipo de datos

text

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Similar models

Unscheduled Visit Study Drug: Accountability - Unscheduled [DA_1E] NCT01117584

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
General Information
Subject lost or misplaced
Item
If subject lost or misplaced study drug, indicate replacement information below.
text
Dispensed Date
Item
Dispensed Date
date
Replacement Kit Number
Item
Replacement Kit Number
text
No. of Capsules/Tablets dispensed
Item
No. of Capsules/Tablets dispensed
float
Any Containers Returned
Item
Were any of the wallets within the kit returned?
boolean
Returned Date
Item
Returned Date
date
No. of Capsules/Tablets returned
Item
No. of Capsules/Tablets returned
float
Comment
Item
Comment
text
Volver a la parte superior de la página