Inglés

Attach each page of the Chest X-ray 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 formularios  
Ccrr Module For Chest X-ray Report Shuttle (cxrs)
Descripción

Ccrr Module For Chest X-ray Report Shuttle (cxrs)

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

Pt.ID

Tipo de datos

text

Institution ID:
Descripción

InstitutionNo.

Tipo de datos

text

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

Patient Initials

Tipo de datos

text

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

InstitutionName

Tipo de datos

text

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Similar models

Attach each page of the Chest X-ray 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 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Ccrr Module For Chest X-ray Report Shuttle (cxrs)
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
Volver a la parte superior de la página