Medical condition
Only in the absence of a diagnosis, record the signs and symptoms on separate lines
text
Conditions from which the subject is currently suffering, regardless of how long they have been present. If the subject has had a recurring condition that is not present at the time of the assessmen, it can be classed as current if, in the Investigator's opinion it is likely to recur during the study.
boolean
Conditions from which the subject has sufferedin the past, but are no longer present. A past condition may have stopped as recently as the day prior to being assessed.
boolean
Physical Examination
day month year
date
Indicate current physical findings by tick the appropriate box(es) below.
integer
"Not done" only applicable for: Breasts, Urogenital, Pelvis and Rectal. They are prefilled for this study.
text
If you tick abnormal in "Examination status", describe concisely: [different findings should be separated by either a (;) or a (/)]
text
Vital Signs general
Height
integer
Weight
float
Body mass index
float
Vital Signs, cardiac
day month year
date
Planned Relative Time
integer
00:00-23:59
time
Blood Pressure Supine, systolic
integer
Blood Pressure Supine, diastolic
integer
Heart Rate
integer