Identification
Last Name
text
First Name
Maiden Name
Birth Date
date
Birth City
Birth Country
Gender
Patient Code
Address
City
Zip Code
State
Country
Home Phone
Work Phone
Other Number
Email
Deceased
boolean
Health Insurance
Health Insurance Code
Keywords
Clinical Study Code
Marital Status
integer
Education
Employment
Medical History
Entry in the clinic
Referred by
Name (referred by)
Visit Frequency Planned
Nb Relapses since 1st Symptoms
Ethnic Origin
Hla Typing Done
Dominant hand