Unnamed2
Vital Status
Patient'sVitalStatus
text
DeathDate/LastContactDate
date
DeathReason
text
DeathReason,Specify
text
OffTreatmentReason
text
ProgressionDate
date
OffTreatmentReason,ComplicatingDisease
text
error,specify
text
OffTreatmentReason,Other
text
LastDoseDate
date
Unnamed3
Comments
text
InvestigatorSignature
text
InvestigatorSignatureDate
date
Ccrr Module For Off-treatment Form