Prenatal Record - National Archives and Records Administration

DEF'll'UTION OF CODES
PAST MEDICAL HISTORY
FOBM OB-6 CABD 1306
CABD
COIDMN
1. Card Number
Code: 1
2. Form Number
Code: 306
3· Revision Number *
Code: 0 - Form Dated:
1 - Form Dated:
1/59
Rev. ll/59
4. :NllmB Number
Item 1
Nine-digit number for Patient Identification
Code: As given
5· Date Form Completed
Item 4
Six-digit code for month (co:ls. 15-16),
day (co:ls. 17-18), and year (co:ls. 19-20)
Code:
As given
99 -Month., day and/or year unknown
6. Number of Hospitalizations
Item 5
Code: 0 - None
1-7 - Number reported
8 - 8 or more
9 -Unknown
1
2-4
5
6-14
15-20
21
7- HOSPITALIZATION - I 22-27
nlness or Disability ( cols. 22-23)
Item 8
Code: See Attacbment, "Illness or Disability
Codes", page OB 5-10
Date (co1s • 24-27)
Item 6 -
Four-digit code for month (cols. 24-25),
year (cols. 26-27)
Code: As given
0000 - None
99 - Month a:o.d/or year unknown
Note: O's in entire field • no hospita~zation
* Item numbers refer to Form Dated: ll/59
and
Reproduced at the National Archives
II.A.99
OB-6