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APPENDIX F SPELLING WORDS FOR SuperMICAR DATA ENTRY

APPENDIX F SPELLING WORDS FOR SuperMICAR DATA ENTRY

APPENDIX F SPELLING WORDS FOR SuperMICAR DATA ENTRY

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<strong>APPENDIX</strong> J <strong>FOR</strong>MAT –– EXERCISE 3 - ANSWERS<br />

Certificate 1<br />

Certificate Number Sex Date of Death<br />

000001 F 01/01<br />

Age Unit Age Field State of Death<br />

55 YEARS AS<br />

Part I Duration<br />

a. CARDIAC ARREST AND PNEUMONIA<br />

b. PULMONARY EMBOLISM & CHF<br />

c. CANCER OF LUNG WITH METASTASIS TO SPINE<br />

d.<br />

Part II<br />

Was Autopsy Performed Were Autopsy Finding Uses Tobacco Use Contribute to<br />

death<br />

Pregnancy Manner of Death Date of Surgery Activity<br />

Code<br />

Date of Injury Time of Injury Injury at Work<br />

Place of Injury<br />

Injury Description<br />

Transportation, Specify<br />

Certifier D State Specific Data<br />

N<br />

J-1 2s January 2006<br />

N

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