ID
6268
Description
CALGB: 80101 BLOOD SAMPLE TRACKING FORM Chemotherapy and Radiation Therapy After Surgery in Treating Patients With Stomach or Esophageal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9DA6CD3D-FA7B-5976-E034-080020C9C0E0
Link
Keywords
Versions (3)
- 12/18/14 12/18/14 - Martin Dugas
- 6/2/15 6/2/15 -
- 6/3/15 6/3/15 -
Uploaded on
December 18, 2014
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Esophageal Cancer NCT00052910 Pathology - CALGB: 80101 BLOOD SAMPLE TRACKING FORM - 2029956v3.0
No Instruction available.
- StudyEvent: CALGB: 80101 BLOOD SAMPLE TRACKING FORM
Description
Unnamed2
Description
PatientName,Last
Data type
text
Description
ParticipatingGroupCode
Data type
text
Description
PatientMedicalRecordNumber
Data type
text
Description
Particip.GroupProtocolNumber
Data type
double
Description
InstitutionName
Data type
text
Description
PatientStudyID,ParticipatingGroup
Data type
text
Description
To Be Completed By Submitting Institution
Description
Specimenw/FormInd
Data type
text
Description
Specifyreason
Data type
text
Description
SpecimenCollectionDate
Data type
date
Description
WholeBloodTubesSubmittedCount
Data type
double
Alias
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus ObjectClass
- C41067
- UMLS 2011AA ObjectClass
- C1608383
- NCI Thesaurus Property
- C25695
- UMLS 2011AA Property
- C1515023
- NCI Metathesaurus Property
- C0175730
Description
SpecimenCollectionTime
Data type
text
Description
PersonSpecimenSubmittedName
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C19157
- UMLS 2011AA Property
- C0370003
- NCI Thesaurus Property
- C25695
- UMLS 2011AA Property
- C1515023
Description
PhoneNumber
Data type
double
Description
To Be Completed By Receiving Institution/laboratory
Description
SpecimenReceivedDate
Data type
date
Description
SpecimenID
Data type
double
Description
PersonSpecimenReceivedName
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus Property
- C19157
- UMLS 2011AA Property
- C0370003
Description
SpecimenEvaluableInd
Data type
text
Description
PhoneNumber
Data type
double
Description
Samplecondition
Data type
text
Similar models
No Instruction available.
- StudyEvent: CALGB: 80101 BLOOD SAMPLE TRACKING FORM
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C0750480 (UMLS 2011AA ValueDomain)
C41067 (NCI Thesaurus ObjectClass)
C1608383 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
C0175730 (NCI Metathesaurus Property)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)