Englisch

Comment Log; Investigator's Statement

1 Formulare  
Administrative
Beschreibung

Administrative

Alias
UMLS CUI-1
C1320722
Patient's initials
Beschreibung

Patient's initials

Datentyp

text

Alias
UMLS CUI [1]
C2986440
Patient's trial number
Beschreibung

Patient's trial number

Datentyp

text

Alias
UMLS CUI [1]
C2348585
Center number
Beschreibung

Center number

Datentyp

text

Alias
UMLS CUI [1,1]
C1301943
UMLS CUI [1,2]
C0600091
Comment Log
Beschreibung

Comment Log

Alias
UMLS CUI-1
C0947611
Date
Beschreibung

Date

Datentyp

date

Alias
UMLS CUI [1]
C0011008
Comments
Beschreibung

Comments

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Investigator's Statement
Beschreibung

Investigator's Statement

Alias
UMLS CUI-1
C0008961
UMLS CUI-2
C1710187
Principal Investigator's signature
Beschreibung

I confirm that I have carefully examined all entries on the Case Report Forms for this patient. All Information entered by myself or my colleagues is, to the best of my knowledge, correct as of the date below.

Datentyp

text

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C1521895
Principal Investigator's Name
Beschreibung

Principal Investigator's Name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Signature Date
Beschreibung

Signature Date

Datentyp

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
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Ähnliche Modelle

Comment Log; Investigator's Statement

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative
C1320722 (UMLS CUI-1)
Patient's initials
Item
Patient's initials
text
C2986440 (UMLS CUI [1])
Patient's trial number
Item
Patient's trial number
text
C2348585 (UMLS CUI [1])
Center number
Item
Center number
text
C1301943 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Item Group
Comment Log
C0947611 (UMLS CUI-1)
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Comments
Item
Comments
text
C0947611 (UMLS CUI [1])
Item Group
Investigator's Statement
C0008961 (UMLS CUI-1)
C1710187 (UMLS CUI-2)
Principal Investigator's signature
Item
Principal Investigator's signature
text
C1519316 (UMLS CUI [1,1])
C1521895 (UMLS CUI [1,2])
Principal Investigator's Name
Item
Principal Investigator's Name
text
C2826892 (UMLS CUI [1])
Signature Date
Item
Signature Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Zum Seitenanfang zurückkehren