English

SECTION 1: PATIENTS DEMOGRAPHY AND MEDICAL HISTORY

3 forms  
SECTION 1: PATIENTS DEMOGRAPHY AND MEDICAL HISTORY
Description

SECTION 1: PATIENTS DEMOGRAPHY AND MEDICAL HISTORY

Alias
UMLS CUI-1
C0011298
UMLS CUI-3
C0262926
I) Hospital/Clinic
Description

Hospital

Data type

text

Alias
UMLS CUI [1]
C0019994
II) Date of Notification
Description

undefined item

Data type

date

1. Patient Name:
Description

Patient Name

Data type

text

Alias
UMLS CUI [1]
C1299487
2. Identification Card Number :
Description

Identification Number

Data type

text

Alias
UMLS CUI [1]
C1300638
Old IC
Description

Identification Number

Data type

text

Alias
UMLS CUI [1]
C1300638
Other ID document No
Description

Specific type (eg passport of armed forces ID )

Data type

text

Alias
UMLS CUI [1]
C1300638
3a. Date of Birth:
Description

Date of Birth

Data type

date

Alias
UMLS CUI [1]
C0421451
3b. Age at notification:
Description

Age

Data type

text

Alias
UMLS CUI [1]
C0001779
4. Gender :
Description

Gender

Data type

text

Alias
UMLS CUI [1]
C0079399
5. Ethnic Group
Description

Ethnic Group

Data type

text

Alias
UMLS CUI [1]
C0015031
5. Source of Referral:
Description

Referral by

Data type

text

Alias
UMLS CUI [1]
C2584922
6. Ocular Co-morbidity:
Description

Comorbidity Ocular

Data type

text

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C0015392
7. Pregnancy
Description

Pregnancy

Data type

boolean

Alias
UMLS CUI [1]
C0032961
If Yes —> trimester
Description

Pregnancy Trimesters

Data type

text

Alias
UMLS CUI [1]
C0032982
Back to the top of the page

Similar models

SECTION 1: PATIENTS DEMOGRAPHY AND MEDICAL HISTORY

3 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
SECTION 1: PATIENTS DEMOGRAPHY AND MEDICAL HISTORY
C0011298 (UMLS CUI-1)
C0262926 (UMLS CUI-3)
Hospital
Item
I) Hospital/Clinic
text
C0019994 (UMLS CUI [1])
undefined item
Item
II) Date of Notification
date
Patient Name
Item
1. Patient Name:
text
C1299487 (UMLS CUI [1])
Identification Number
Item
2. Identification Card Number :
text
C1300638 (UMLS CUI [1])
Identification Number
Item
Old IC
text
C1300638 (UMLS CUI [1])
Identification Number
Item
Other ID document No
text
C1300638 (UMLS CUI [1])
Date of Birth
Item
3a. Date of Birth:
date
C0421451 (UMLS CUI [1])
Age
Item
3b. Age at notification:
text
C0001779 (UMLS CUI [1])
Item
4. Gender :
text
C0079399 (UMLS CUI [1])
undefined item
Code List
4. Gender :
CL Item
Male (Male)
C0086582 (UMLS CUI-1)
(Comment:en)
CL Item
Female (Female)
C0015780 (UMLS CUI-1)
(Comment:en)
Item
5. Ethnic Group
text
C0015031 (UMLS CUI [1])
undefined item
Code List
5. Ethnic Group
CL Item
Malay (Malay)
C0024549 (UMLS CUI-1)
(Comment:en)
CL Item
Chinese (Chinese)
C0152035 (UMLS CUI-1)
(Comment:en)
CL Item
Indian (Indian)
C1524069 (UMLS CUI-1)
(Comment:en)
CL Item
Orang Asli (Orang Asli)
C3875078 (UMLS CUI-1)
(Comment:en)
CL Item
Melanau (Melanau)
C3875090 (UMLS CUI-1)
(Comment:en)
CL Item
Iban (Iban)
C3875071 (UMLS CUI-1)
(Comment:en)
CL Item
Bidayuh (Bidayuh)
C3875070 (UMLS CUI-1)
(Comment:en)
CL Item
Others (Others)
C0205394 (UMLS CUI-1)
(Comment:en)
CL Item
Kadazan/Murut /Bajau (Kadazan/Murut /Bajau)
C3875081 (UMLS CUI-1)
(Comment:en)
Item
5. Source of Referral:
text
C2584922 (UMLS CUI [1])
undefined item
Code List
5. Source of Referral:
CL Item
Government OPD/KK/KD (Government OPD/KK/KD)
(Comment:en)
CL Item
GP (GP)
C0017319 (UMLS CUI-1)
(Comment:en)
CL Item
Optometrist/Optician (Optometrist/Optician)
(Comment:en)
CL Item
Ophthalmologist (Ophthalmologist)
C3845861 (UMLS CUI-1)
(Comment:en)
CL Item
Others (Others)
C0205394 (UMLS CUI-1)
(Comment:en)
CL Item
Government Hospital—MO/Specialist (Government Hospital—MO/Specialist)
(Comment:en)
CL Item
Private Hospital—MO/Specialist (Private Hospital—MO/Specialist)
(Comment:en)
Item
6. Ocular Co-morbidity:
text
C0009488 (UMLS CUI [1,1])
C0015392 (UMLS CUI [1,2])
undefined item
Code List
6. Ocular Co-morbidity:
CL Item
None (None)
C0549184 (UMLS CUI-1)
(Comment:en)
CL Item
Cataract (Cataract)
C0086543 (UMLS CUI-1)
(Comment:en)
CL Item
Glaucoma (Glaucoma)
C0017601 (UMLS CUI-1)
(Comment:en)
CL Item
Others (Others)
C0205394 (UMLS CUI-1)
(Comment:en)
Pregnancy
Item
7. Pregnancy
boolean
C0032961 (UMLS CUI [1])
Item
If Yes —> trimester
text
C0032982 (UMLS CUI [1])
undefined item
Code List
If Yes —> trimester
CL Item
1st (1st)
CL Item
2nd (2nd)
CL Item
3rd (3rd)
Back to the top of the page