Inglês

Attach each page of the Imaging Report to a separate Shuttle form. Align the top edge of each page with the horizontal line below. Fax this Shuttle Form with the attached page to the ACOSOG Coordinating Center at 919-668-8466.

1 Formulários  
Ccrr Module For Imaging Report Shuttle (ors)
Descrição

Ccrr Module For Imaging Report Shuttle (ors)

Patient ID (Pt. ID issued during registration or previously issued patient ID)
Descrição

Pt.ID

Tipo de dados

text

Institution ID:
Descrição

InstitutionNo.

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Patient Initials: (F ML)
Descrição

Patient Initials

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution:
Descrição

InstitutionName

Tipo de dados

text

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Similar models

Attach each page of the Imaging Report to a separate Shuttle form. Align the top edge of each page with the horizontal line below. Fax this Shuttle Form with the attached page to the ACOSOG Coordinating Center at 919-668-8466.

1 Formulários
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Ccrr Module For Imaging Report Shuttle (ors)
Pt.ID
Item
Patient ID (Pt. ID issued during registration or previously issued patient ID)
text
InstitutionNo.
Item
Institution ID:
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
Patient Initials
Item
Patient Initials: (F ML)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
InstitutionName
Item
Institution:
text
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