Tracking Information
Institution Name
text
TreatingPhysicianName
text
Medical Record Number
text
Birth Date
date
Social Security Number
float
PatientAddressPostalCode
text
Country of current residence
text
Demographic Information
Racial Group
text
PatientEthnicityCategory
text
PatientPaymentType
text
Patient Height
float
Patient Weight
float
ECOG Performance Status
text
PriorCancerDiagnosisInd-3
boolean
PriorCancerTypeText
text
PriorCancerDiagnosisDate
date
Comments
Footer Module
ParticipatingGroupIdentifierCode
text
Study Number Participating Group
text
Trial subject ID Participating Group
text