Demography
Date of birth
date
Sex
text
Check one
integer
Chek one
integer
Child-Bearing Potential
Pregnancy Test
Physical Examination
Physical Examination
integer
Physical Examination Not Done
integer
Physical Examination Result
integer
If Abnormal, specify
text
Vital Signs
Height
integer
Weight
float
Body mass index
float
Vital Signs
Date (Vital Signs)
date
Planned Relative Time (Vital Signs)
integer
Actual Time (Vital Signs)
time
Systolic Blood Pressure
integer
Diastolic Blood Pressure
integer
Heart Rate (Vital Signs)
integer
Medical Conditions