Englisch

SAE Additional/Follow-Up Information

1 Formulare  
Administrative data
Beschreibung

Administrative data

Subject Identifier
Beschreibung

Subject Identifier

Datentyp

integer

Centre Number
Beschreibung

Centre Number

Datentyp

integer

Randomisation Number
Beschreibung

Randomisation Number

Datentyp

integer

Section 12 SAE Additional/Follow-Up Information
Beschreibung

Section 12 SAE Additional/Follow-Up Information

Use this page to provide any additional details on the SAE not already captured on the previous pages
Beschreibung

Use this page to provide any additional details on the SAE not already captured on the previous pages

Datentyp

text

Investigator's signature
Beschreibung

confirming that the data on this page is accurate and complete

Datentyp

text

Investigator's name (print)
Beschreibung

Investigator's name (print)

Datentyp

text

Date
Beschreibung

Date

Datentyp

date

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Ähnliche Modelle

SAE Additional/Follow-Up Information

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative data
Subject Identifier
Item
Subject Identifier
integer
Centre Number
Item
Centre Number
integer
Randomisation Number
Item
Randomisation Number
integer
Item Group
Section 12 SAE Additional/Follow-Up Information
Use this page to provide any additional details on the SAE not already captured on the previous pages
Item
Use this page to provide any additional details on the SAE not already captured on the previous pages
text
Investigator's signature
Item
Investigator's signature
text
Investigator's name (print)
Item
Investigator's name (print)
text
Date
Item
Date
date
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