Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Body Height
Item
Height
integer
C0005890 (UMLS CUI [1])
Body Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Body mass index
Item
Body mass index
float
C1305855 (UMLS CUI [1])
Clinical Staff Signature
Item
Clinical Staff Signature
text
C0025106 (UMLS CUI [1,1])
C1519316 (UMLS CUI [1,2])
Date of signature
Item
Date of signature
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
American Hispanic race
Item
American Hispanic
boolean
C0019576 (UMLS CUI [1])
Arabic/North African race
Item
Arabic/North African
boolean
C0238604 (UMLS CUI [1])
Black race
Item
Black race
boolean
C0005680 (UMLS CUI [1])
East and South East Asian race
Item
East and South East Asia
boolean
C0003983 (UMLS CUI [1])
Japanese race
Item
Japanese
boolean
C1556094 (UMLS CUI [1])
South Asian race
Item
South Asia
boolean
C1519427 (UMLS CUI [1])
White/Caucasian race
Item
White/Caucasian
boolean
C0043157 (UMLS CUI [1])
Other race
Item
Other
text
C0205394 (UMLS CUI [1,1])
C0034510 (UMLS CUI [1,2])
Other race, specification
Item
If other race, please specify
text
C0205394 (UMLS CUI [1,1])
C0034510 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Item
Was a pregnancy test carried out?
text
C0032976 (UMLS CUI [1,1])
C1272682 (UMLS CUI [1,2])
Code List
Was a pregnancy test carried out?
No pregnancy test, reason
Item
If no pregnancy test, please specify reason
text
C0566251 (UMLS CUI [1,1])
C3841220 (UMLS CUI [1,2])
C0032976 (UMLS CUI [1,3])
Date of pregnancy test
Item
If pregnancy test was performed, please note date of test
date
C0032976 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Time of pregnancy test
Item
If pregnancy test was performed, please note time of test
time
C0032976 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Item
Pregnancy Test result
text
C0427777 (UMLS CUI [1])
Code List
Pregnancy Test result
Item
Pregnancy test type
integer
C0032976 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Code List
Pregnancy test type
CL Item
Dipstick urine HCG (1)
Other pregnancy test type
Item
If other pregnancy test type, please specify
text
C0205394 (UMLS CUI [1,1])
C0032976 (UMLS CUI [1,2])
C0332307 (UMLS CUI [1,3])