ID

43164

Description

On-Study Form NCT00058149 A Phase III, Randomized Study of Gemcitabine (Fixed-Dose Rate Infusion) and Oxaliplatin (NSC 266046) Versus Gemcitabine (Fixed-Dose Rate Infusion) Versus Gemcitabine (30-Minute Infusion) in Pancreatic Carcinoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A65D6B91-79C6-4288-E034-0003BA0B1A09

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A65D6B91-79C6-4288-E034-0003BA0B1A09

Mots-clés

Versions (4)
  1. 19/09/2012 19/09/2012 -
  2. 28/05/2015 28/05/2015 -
  3. 03/06/2015 03/06/2015 -
  4. 20/09/2021 20/09/2021 -
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20 septembre 2021

DOI

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Licence

Creative Commons BY-NC 3.0 Legacy
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On-Study Form NCT00058149

Anglais

No Instruction available.

1 Formulaires  
  1. StudyEvent: On-Study Form
    1. No Instruction available.
ECOG clinical trial administrative data
Description

ECOG clinical trial administrative data

ECOG Protocol No.
Description

ECOGProtocolNo.

Type de données

text

ECOG Patient ID
Description

ECOGPatientID

Type de données

text

Registration Step
Description

RegistrationStep

Type de données

text

Patient?s Name
Description

Patient'sName

Type de données

text

Participating Group Protocol No.
Description

ParticipatingGroupProtocolNo.

Type de données

text

Participating Group Patient ID
Description

ParticipatingGroupPatientID

Type de données

text

Institution/Affiliate
Description

MainMemberInstitution/Affiliate

Type de données

text

Are data amended?
Description

AmendedDataInd

Type de données

boolean

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Form No.
Description

FormNo.

Type de données

text

Patient vital status
Description

Patient vital status

Performance status
Description

PerformanceStatus

Type de données

text

Weight loss in previous 6 months (choose one)
Description

WeightLossPriorSixMonths

Type de données

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C3445
UMLS 2011AA Property
C1262477
Disease Description
Description

Disease Description

Date of initial diagnosis of primary tumor (first positive biopsy date)
Description

FirstPositiveBiopsyDate

Type de données

date

Date of most recent prior recurrence (if patient has responded to prior treatment)
Description

PriorRecentRecurrenceDate

Type de données

date

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C25279
UMLS 2011AA Property
C0332162
Primary site (choose one)
Description

PrimarySite

Type de données

text

Primary Site, other specify
Description

PrimarySite,Other

Type de données

text

Histologic grade (choose one)
Description

HistologicGrade

Type de données

text

Histologic Type (choose one)
Description

HistologicType

Type de données

text

Other specify
Description

HistologicType,OtherName

Type de données

text

Is there histologic proof of residual or metastatic malignant disease?
Description

Istherehistologicproofofresidualormetastaticmalignantdisease?

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ValueDomain-2
C25180
UMLS 2011AA ValueDomain-2
C1522602
Site(s) Of Involvement
Description

Site(s) Of Involvement

Pancreas
Description

Primarytumor/Pancreas

Type de données

boolean

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ValueDomain-2
C25180
UMLS 2011AA ValueDomain-2
C1522602
Regional lymph nodes
Description

RegionalLymphNode(s)Ind

Type de données

boolean

Distant lymph nodes
Description

DistantLymphNode(s)Ind

Type de données

boolean

Adjacent viscera/vessels
Description

Adjacentviscera/vessels

Type de données

boolean

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ValueDomain-2
C25180
UMLS 2011AA ValueDomain-2
C1522602
Liver
Description

LiverSiteInd

Type de données

boolean

Peritoneum
Description

PeritoneumInd

Type de données

boolean

Lung
Description

LungSiteInd

Type de données

boolean

Bone
Description

BoneSiteInd

Type de données

boolean

Other
Description

OtherSiteInd

Type de données

boolean

Other specify
Description

OtherSiteName

Type de données

text

Advanced Disease Status at Registration
Description

AdvancedDiseaseRegistrationStatus

Type de données

text

CEA (ng/dl)
Description

CEA

Type de données

text

CEA ULN
Description

LaboratoryProcedureCarcinoembryonicAntigenOutcomeUpperLimitNormalValue

Type de données

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C25159
UMLS 2011AA Property
C0007082
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property-2
C1274040
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C25706
UMLS 2011AA ValueDomain-2
C1519815
Date CEA obtained (M D Y)
Description

CarcinoembryonicAntigenSpecimenCollectionDate

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25159
UMLS 2011AA ObjectClass
C0007082
NCI Thesaurus Property
C25453
UMLS 2011AA Property
C1516698
NCI Thesaurus ObjectClass-2
C19157
UMLS 2011AA ObjectClass-2
C0370003
CA19-9 (U/ml)
Description

CA19-9

Type de données

text

Date CA19-9 obtained (M D Y)
Description

DateCA19-9obtained

Type de données

text

Baseline Hematology/chemistry
Description

Baseline Hematology/chemistry

WBC count (x1000), LLN
Description

WBCcount(x1000),LLN

Type de données

text

WBC count (x1000), Value
Description

Lab,Hematology,WBC

Type de données

float

Date Obtained (M D Y)
Description

Lab,Hematology,SampleCollectionDate

Type de données

date

Granulocyte count (AGC/ANC), Value
Description

Lab,Hematology,GranulocyteCount

Type de données

float

Platelets count (x1000), LLN
Description

Plateletscount(x1000),LLN

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C25555
UMLS 2011AA ValueDomain-2
C1518030
Platelets count (x1000), Value
Description

Lab,Hematology,Platelets

Type de données

float

Hemoglobin (g/dl), LLN
Description

Hemoglobin(g/dl),LLN

Type de données

text

Hemoglobin (g/dl), Value
Description

Lab,Hematology,Hemoglobin

Type de données

float

Albumin (g/dl), LLN
Description

Albumin(g/dl),LLN

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C25555
UMLS 2011AA ValueDomain-2
C1518030
Albumin (g/dl), Value
Description

Lab,Chemistry,Albumin

Type de données

float

Creatinine (mg/dl), ULN
Description

Creatinine(mg/dl),ULN

Type de données

text

Creatinine (mg/dl), Value
Description

Lab,Renal,Creatinine

Type de données

float

SGOT (AST) (U/L), ULN
Description

SGOT(AST)ULN

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C25706
UMLS 2011AA ValueDomain-2
C1519815
SGOT (AST) (U/L), Value
Description

Lab,Hepatic,SGOT

Type de données

float

Bilirubin (mg/dl), ULN
Description

Bilirubin(mg/dl),ULN

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C25706
UMLS 2011AA ValueDomain-2
C1519815
Bilirubin (mg/dl), Value
Description

Lab,Hepatic,Bilirubin

Type de données

float

Prior Therapy
Description

Prior Therapy

Prior radiation therapy? (Choose one:)
Description

PriorRTInd

Type de données

boolean

Prior RT begin date (M D Y)
Description

PriorRTBeginDate

Type de données

date

Prior RT end date (M D Y)
Description

PriorRTEndDate

Type de données

date

RT site:
Description

RTSite

Type de données

text

Ccrr Module For On-study Form
Description

Ccrr Module For On-study Form

Site(s) of Involvement, Other specify
Description

DiseaseInvolvementSite,Other

Type de données

text

Specify agents
Description

Specifyagents

Type de données

text

Prior surgery
Description

PriorSurgeryInd

Type de données

boolean

Specify prior thrombotic event
Description

Specifypriorthromboticevent

Type de données

text

Does the patient have a prior history of deep vein thrombosis or pulmonary embolus?
Description

Doesthepatienthaveapriorhistoryofdeepveinthrombosisorpulmonaryembolus?

Type de données

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Prior thrombosis?
Description

Priorthrombosis?

Type de données

boolean

Time frame of thrombosis
Description

Timeframeofthrombosis

Type de données

text

Prior embolus?
Description

Priorembolus?

Type de données

boolean

Time frame of embolus
Description

Timeframeofembolus

Type de données

text

date of prior surgery
Description

PriorSurgeryDate

Type de données

date

Date of initial diagnosis of unresectable locally advanced disease
Description

InitialDiagnosisDate,LocallyAdvanced

Type de données

date

Date of initial diagnosis of metastatic disease
Description

InitialDiagnosisDate,Metastatic

Type de données

date

Is measurable disease present?
Description

DiseaseAssessment,MeasurableInd

Type de données

boolean

Is non-measurable disease present?
Description

DiseaseAssessment,Non-measurableInd

Type de données

boolean

Prior adjuvant chemotherapy end date
Description

PriorAdjuvantChemotherapyEndDate

Type de données

date

Prior adjuvant chemotherapy begin date
Description

PriorAdjuvantChemotherapyBeginDate

Type de données

date

Footer module
Description

Footer module

Comments
Description

Comments

Type de données

text

Investigator Signature
Description

InvestigatorSignature

Type de données

text

Alias
NCI Thesaurus Property
C25678
UMLS 2011AA Property
C1519316
NCI Thesaurus ObjectClass
C17089
UMLS 2011AA ObjectClass
C0035173
Date
Description

InvestigatorSignatureDate

Type de données

date

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Similar models

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1 Formulaires
  1. StudyEvent: On-Study Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
ECOG clinical trial administrative data
ECOGProtocolNo.
Item
ECOG Protocol No.
text
ECOGPatientID
Item
ECOG Patient ID
text
RegistrationStep
Item
Registration Step
text
Patient'sName
Item
Patient?s Name
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
ParticipatingGroupPatientID
Item
Participating Group Patient ID
text
MainMemberInstitution/Affiliate
Item
Institution/Affiliate
text
AmendedDataInd
Item
Are data amended?
boolean
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
FormNo.
Item
Form No.
text
Item Group
Patient vital status
Item
Performance status
text
CL.2
Code List
Performance status
CL Item
0 (Fully active, able to carry on all pre-disease performance without restriction (Karnofsky 90-100))
C0919414 (NCI Metathesaurus)
CL Item
1 (Restricted in physically strenuous activity but ambulatory (K 70-80))
CL Item
2 (Ambulatory and capable of all selfcare but unable to carry out any work activities (K 50-60))
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours (K 30-40))
CL Item
4 (completely disabled (K 10-20))
Item
Weight loss in previous 6 months (choose one)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3445 (NCI Thesaurus Property)
C1262477 (UMLS 2011AA Property)
CL.3
Code List
Weight loss in previous 6 months (choose one)
CL Item
<5% Of Body Weight (less than 5% of body weight)
CL Item
5 To <10% Of Body Weight (5 - <10% of body weight)
CL Item
10 To <20% Of Body Weight (10 - <20% of body weight)
CL Item
> Or = 20% Of Body Weight (greater than or equal to 20% of body weight)
Item Group
Disease Description
FirstPositiveBiopsyDate
Item
Date of initial diagnosis of primary tumor (first positive biopsy date)
date
PriorRecentRecurrenceDate
Item
Date of most recent prior recurrence (if patient has responded to prior treatment)
date
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25279 (NCI Thesaurus Property)
C0332162 (UMLS 2011AA Property)
Item
Primary site (choose one)
text
CL.4
Code List
Primary site (choose one)
CL Item
Head Of Pancreas (Head of pancreas)
C0227579 (NCI Metathesaurus)
CL Item
Body Of Pancreas (Body of pancreas)
C0227582 (NCI Metathesaurus)
CL Item
Tail Of Pancreas (Tail of pancreas)
C0227590 (NCI Metathesaurus)
CL Item
Uncinate Process (Uncinate process)
CL Item
Diffuse (Diffuse)
C14175 (NCI Thesaurus)
C0205219 (UMLS 2011AA)
CL Item
Other, Specify (Other)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
PrimarySite,Other
Item
Primary Site, other specify
text
Item
Histologic grade (choose one)
text
CL.5
Code List
Histologic grade (choose one)
CL Item
Tumor Is Well Differentiated According To Who Grading System (Well differentiated)
CL Item
Tumor Is Moderately Differentiated According To Who Grading System (Moderately differentiated)
CL Item
Tumor Is Poorly Differentiated According To Who Grading System (Poorly differentiated)
CL Item
Tumor Is Undifferentiated According To Who Grading System (Undifferentiated)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Histologic Type (choose one)
text
CL.6
Code List
Histologic Type (choose one)
CL Item
Ductal Adenocarcinoma (Ductal adenocarcinoma)
CL Item
Neuroendocrine Carcinoma (Neuroendocrine carcinoma)
C3773 (NCI Thesaurus)
C0206695 (UMLS 2011AA)
CL Item
Mixed-type (ductal-endocrine Or Acinar-endocrine) (Mixed ductal - endocrine carcinoma)
CL Item
Undifferentiated (anaplastic) Carcinoma (Undifferentiated (anaplastic) carcinoma)
CL Item
Other, Specify (Other)
HistologicType,OtherName
Item
Other specify
text
Item
Is there histologic proof of residual or metastatic malignant disease?
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain-2)
C1522602 (UMLS 2011AA ValueDomain-2)
CL.7
Code List
Is there histologic proof of residual or metastatic malignant disease?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item Group
Site(s) Of Involvement
Primarytumor/Pancreas
Item
Pancreas
boolean
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain-2)
C1522602 (UMLS 2011AA ValueDomain-2)
RegionalLymphNode(s)Ind
Item
Regional lymph nodes
boolean
DistantLymphNode(s)Ind
Item
Distant lymph nodes
boolean
Adjacentviscera/vessels
Item
Adjacent viscera/vessels
boolean
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain-2)
C1522602 (UMLS 2011AA ValueDomain-2)
LiverSiteInd
Item
Liver
boolean
PeritoneumInd
Item
Peritoneum
boolean
LungSiteInd
Item
Lung
boolean
BoneSiteInd
Item
Bone
boolean
OtherSiteInd
Item
Other
boolean
OtherSiteName
Item
Other specify
text
Item
Advanced Disease Status at Registration
text
CL.17
Code List
Advanced Disease Status at Registration
CL Item
Initial Diagnosis (Initial diagnosis)
CL Item
Recurrence (Recurrence)
CEA
Item
CEA (ng/dl)
text
LaboratoryProcedureCarcinoembryonicAntigenOutcomeUpperLimitNormalValue
Item
CEA ULN
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25159 (NCI Thesaurus Property)
C0007082 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
CarcinoembryonicAntigenSpecimenCollectionDate
Item
Date CEA obtained (M D Y)
text
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25159 (NCI Thesaurus ObjectClass)
C0007082 (UMLS 2011AA ObjectClass)
C25453 (NCI Thesaurus Property)
C1516698 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
CA19-9
Item
CA19-9 (U/ml)
text
DateCA19-9obtained
Item
Date CA19-9 obtained (M D Y)
text
Item Group
Baseline Hematology/chemistry
WBCcount(x1000),LLN
Item
WBC count (x1000), LLN
text
Lab,Hematology,WBC
Item
WBC count (x1000), Value
float
Lab,Hematology,SampleCollectionDate
Item
Date Obtained (M D Y)
date
Lab,Hematology,GranulocyteCount
Item
Granulocyte count (AGC/ANC), Value
float
Plateletscount(x1000),LLN
Item
Platelets count (x1000), LLN
float
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
Lab,Hematology,Platelets
Item
Platelets count (x1000), Value
float
Hemoglobin(g/dl),LLN
Item
Hemoglobin (g/dl), LLN
text
Lab,Hematology,Hemoglobin
Item
Hemoglobin (g/dl), Value
float
Albumin(g/dl),LLN
Item
Albumin (g/dl), LLN
float
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
Lab,Chemistry,Albumin
Item
Albumin (g/dl), Value
float
Creatinine(mg/dl),ULN
Item
Creatinine (mg/dl), ULN
text
Lab,Renal,Creatinine
Item
Creatinine (mg/dl), Value
float
SGOT(AST)ULN
Item
SGOT (AST) (U/L), ULN
float
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
Lab,Hepatic,SGOT
Item
SGOT (AST) (U/L), Value
float
Bilirubin(mg/dl),ULN
Item
Bilirubin (mg/dl), ULN
float
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
Lab,Hepatic,Bilirubin
Item
Bilirubin (mg/dl), Value
float
Item Group
Prior Therapy
PriorRTInd
Item
Prior radiation therapy? (Choose one:)
boolean
PriorRTBeginDate
Item
Prior RT begin date (M D Y)
date
PriorRTEndDate
Item
Prior RT end date (M D Y)
date
RTSite
Item
RT site:
text
Item Group
Ccrr Module For On-study Form
DiseaseInvolvementSite,Other
Item
Site(s) of Involvement, Other specify
text
Specifyagents
Item
Specify agents
text
PriorSurgeryInd
Item
Prior surgery
boolean
Item
Specify prior thrombotic event
text
CL.20
Code List
Specify prior thrombotic event
CL Item
Thrombosis (thrombosis)
C26891 (NCI Thesaurus)
C0040053 (UMLS 2011AA)
CL Item
Both Thrombosis And Embolus (both thrombosis and embolus)
CL Item
Embolus (embolus)
C0013932 (NCI Metathesaurus)
Doesthepatienthaveapriorhistoryofdeepveinthrombosisorpulmonaryembolus?
Item
Does the patient have a prior history of deep vein thrombosis or pulmonary embolus?
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Priorthrombosis?
Item
Prior thrombosis?
boolean
Item
Time frame of thrombosis
text
CL.23
Code List
Time frame of thrombosis
CL Item
> 1 Year Prior To Diagnosis Of Primary Cancer (> 1 year prior to diagnosis of primary cancer)
CL Item
Within 1 Year Of Diagnosis Of Primary Cancer (within 1 year of diagnosis of primary cancer)
Priorembolus?
Item
Prior embolus?
boolean
Item
Time frame of embolus
text
CL.25
Code List
Time frame of embolus
CL Item
> 1 Year Prior To Diagnosis Of Primary Cancer (> 1 year prior to diagnosis of primary cancer)
CL Item
Within 1 Year Of Diagnosis Of Primary Cancer (within 1 year of diagnosis of primary cancer)
PriorSurgeryDate
Item
date of prior surgery
date
InitialDiagnosisDate,LocallyAdvanced
Item
Date of initial diagnosis of unresectable locally advanced disease
date
InitialDiagnosisDate,Metastatic
Item
Date of initial diagnosis of metastatic disease
date
DiseaseAssessment,MeasurableInd
Item
Is measurable disease present?
boolean
DiseaseAssessment,Non-measurableInd
Item
Is non-measurable disease present?
boolean
PriorAdjuvantChemotherapyEndDate
Item
Prior adjuvant chemotherapy end date
date
PriorAdjuvantChemotherapyBeginDate
Item
Prior adjuvant chemotherapy begin date
date
Item Group
Footer module
Comments
Item
Comments
text
InvestigatorSignature
Item
Investigator Signature
text
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
InvestigatorSignatureDate
Item
Date
date
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