English

Part 2: Treatment Period - Day 14- Physical Examination Form

1 forms  
Administrative data
Description

Administrative data

Subject Identifier
Description

Subject Identifier

Data type

integer

Physical Examination
Description

Physical Examination

Date of Assessment
Description

Date of Assessment

Data type

date

Indicate current physical findings by marking the appropriate box(es) below and if Abnormal, describe concisely: [different findings should be separated by either a (:) or a (/)].
Description

Indicate current physical findings by marking the appropriate box(es) below and if Abnormal, describe concisely: [different findings should be separated by either a (:) or a (/)].

Data type

text

Hair and Skin
Description

Hair and Skin

Data type

text

Lymph nodes
Description

Lymph nodes

Data type

text

Eyes
Description

Eyes

Data type

text

Ears. Nose and Throat
Description

Ears. Nose and Throat

Data type

text

Breasts
Description

Breasts

Data type

text

Respiratory
Description

Respiratory

Data type

text

Cardiovascular
Description

Cardiovascular

Data type

text

Abdomen
Description

Abdomen

Data type

text

Urogenital
Description

Urogenital

Data type

text

Pelvic
Description

Pelvic

Data type

text

Rectal
Description

Rectal

Data type

text

Musculoskeletal
Description

Musculoskeletal

Data type

text

Neurological
Description

Neurological

Data type

text

Mental Status
Description

Mental Status

Data type

text

Back to the top of the page

Similar models

Part 2: Treatment Period - Day 14- Physical Examination Form

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
Subject Identifier
Item
Subject Identifier
integer
Item Group
Physical Examination
Date of Assessment
Item
Date of Assessment
date
Indicate current physical findings by marking the appropriate box(es) below and if Abnormal, describe concisely: [different findings should be separated by either a (:) or a (/)].
Item
Indicate current physical findings by marking the appropriate box(es) below and if Abnormal, describe concisely: [different findings should be separated by either a (:) or a (/)].
text
Item
Hair and Skin
text
Hair and Skin
Code List
Hair and Skin
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Lymph nodes
text
Lymph nodes
Code List
Lymph nodes
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Eyes
text
Eyes
Code List
Eyes
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Ears. Nose and Throat
text
Ears. Nose and Throat
Code List
Ears. Nose and Throat
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Breasts
text
Breasts
Code List
Breasts
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Item
Respiratory
text
Respiratory
Code List
Respiratory
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Cardiovascular
text
Cardiovascular
Code List
Cardiovascular
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Abdomen
text
Abdomen
Code List
Abdomen
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Urogenital
text
Urogenital
Code List
Urogenital
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Item
Pelvic
text
Pelvic
Code List
Pelvic
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Item
Rectal
text
Rectal
Code List
Rectal
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Item
Musculoskeletal
text
Musculoskeletal
Code List
Musculoskeletal
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Neurological
text
Neurological
Code List
Neurological
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
Mental Status
text
Mental Status
Code List
Mental Status
CL Item
Normal (1)
CL Item
Abnormal (2)
Back to the top of the page