Prenatal Record - National Archives and Records Administration

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Reproduced at the National Archives H H • > .... • 0 "' @ I -...! For~ Ite~ ~umbers linked to nata Ite~s on OH-7, Tnfer.ttous Ofsease anct svstem Review I TE'' [lATA ON tr~M CARD FORM In NIIM FROM TO DAfA TrF.M Nli"'F: 447 ••• ns-7 0101 17 18 Form ns-7 d~te ( j I'll'/) 446 ••• 08•7 0107 15 16 Form OB-7 dAtP. {'110) 449 ••• n8•7 0101 19 10 Form na-7 date fvr> 45t ••• os-7 0101 24 74 Childhood diseases: chiC"ICen POX ' t 452 ••• n8-7 0307 2'\ 76 Ch111hood dfsea~es: chicl
DEFINITION OF CODES nlFECTIOO'S DISEASE AND SYSTEM REV l.:.W' FOEM OB-7 CARD 0307 FIEI.D l. Card Number Code: 0 2. Form Number Code: 307 3. Revision Number * Code: 0 - Form Dated: l/59 4.. NnmE Number Nine-digit number for Patient Identification Code: As g1ven 5. Date Blstory Taken Six-digit code for month (cols. 15-16), day (cols. 17-18) and year (cols. 19-20) Code: As given 99 - Month and/or day, and/or year u.nlmown CARD COWMN l 2-4 5 6-14. 15-20 CRIUlHOOD DISEASE 6. Pertussis Item l Three-digit code for response (col. 21), and Age of Onset (eels. 22-23) • Code-for column 21: 0 -No l- Yes 2 - Yes (more than one episode) 9 -Unknown 21-23 1· Code· for colUZDJ:l.s 22-23: 00 - Birth to ll months Ol-50 • As giyen 05 - Pre-school 95 - School age 99 - Unknown, no disease Note: !'or fie:!.d, no disease • 099 ChiCken Pox Item 1 Cede: Same as in Field 6 8. ~ Item l Code: Same as in Field 6 27-29 II.A.l21 OB-7 Reproduced at the National Archives
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NINCDS COLLABORATIVE PERINATAL PROJ
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NINCDS COLLABORATIVE PERINATAL PROJ
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INTRODUCTION DOCUMENT OBJECTIVES AN
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Forms The first forms used in the s
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Reproduced at the National Archives
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selection. A n1n was used for patie
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, researcher is more likely to look
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TABLE 3. Abbreviations for Person,
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TABLE 4. Definition of Person, Time
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TABLE 4. Definition of Person, Time
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CONTENTS AR-1/0B-1 OB-2 OB-3 OB
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AR-1 Obstetrical Administrative Rec
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DEFINITION OF CODES {Continued) FOR
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... 1;:: I ~ .J.I'40JI.!9d jl5 !
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ADMINISTRATIVE RECORD MANUAL PHS-30
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ADMI!liSTRATIVE RECORD ;fl.A.TI.TUA
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-· IID'~7-- '·"'-- ':!e- ~ l·-~
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OB-1: OBSTETRICAL· ADMINISTRATIVE
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Par. 3 10 - Religion. Record as Cat
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OB-2 Reproductive History Form OB-2
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COLIII:•IOoa-& ,.., REPRODUCTIVE
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DEFTIITTION OF CODES (Continued) FI
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1 Reproduced at the National Archiv
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R~PRODUCTI\~ HISTORY (Con't.) C3-2
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REPRODUCTIVE HISTORY (Con•t.) C3-
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OB-3 History Since Last Menstrual P
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eoL"-aooa.a ACV. n-et • HISTORY S
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DEFINITION OF CODES (Continued) FOR
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DEFJNITION OF CODES (Continued) FOR
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"' 1: : ~~ :; "':J. !~ ~ ~ :~ ~ ; :
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HISTORY SINCE LAST 1-ENSTRUAL PERIO
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HISTORY SINCE ~T MENSTRQ~ P~RIOD {C
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OB-4 Gynecological History Form OB-
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COL.,.-aaaa-4 RIEV. tt-11 • GYNEC
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DEFINITION OF CODES GYNECOLOGICAL H
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DEFINITION OF CODES (Continued) FIE
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'? I~ 1: :1\ j; t:: t; ....J 7 ,.
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GY1~F..COLOGICAL HISTORY (Con't.) O
Page 91 and 92: 08-5 Recent Medical History Form 08
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Page 99 and 100: DEFINITION OF CODES RECENT MEDICAL
Page 101 and 102: DEl!'INITION OF CODES (Continued) F
Page 103 and 104: DEFINITION OF CODES (Continued) FOR
Page 107 and 108: ILL..'1ESS OR DISABILITY CODES (Con
Page 111 and 112: RECENT MEDICAL HISTORY (Con 1 t) OB
Page 113 and 114: OB-6 Past Medical History Form OB-6
Page 117 and 118: z PAST MEDICAL HISTORY (Interviewer
Page 121 and 122: DEF'll'UTION OF CODES PAST MEDICAL
Page 123 and 124: DEF'INli'ION OF CODES (Continued) F
Page 125 and 126: DEFINITION OF CODES (Continued) u.
Page 127 and 128: DEFINITION OF CODES (Continued) FOO
Page 131 and 132: PAST HEDICAL HISTORY (Con't) Item 1
Page 133 and 134: HISTORY TAKEN BY PAST MEDICAL HISTO
Page 135 and 136: OB-7 Infectious Disease and System
Page 139 and 140: COLIII.•I00 ..7 ,... INFECTIOUS D
Page 141: C:OLft-IOOa-7 1··· INFECTIOUS DI
Page 145 and 146: DEl''ll'IITION OF C:JDES ( Conti:::
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Page 149 and 150: l!:i i!;T!IJIJ;: IIJ;;:..f,;:l·: .
Page 151 and 152: INF~TIOUS DIS~S~ ;~D SYSTEM REVIEW
Page 153 and 154: OB-8 Repeat Prenatal History Form O
Page 157 and 158: I. ftATIIMT IDfNTIPICATIOM REPEAT P
Page 163 and 164: DEFINITION OF CODES (Continued) FIE
Page 165 and 166: ~ :: : j: ~ : I~ =r ; Ia ~ ~ !~ ;
Page 167 and 168: ,;.-~ 1•1. 1J;,.... - ~ .. u;W'o'
Page 169 and 170: OB-9 Prenatal Record Form OB-9, Pre
Page 177 and 178: C:OL.II.·- I•It NU\E IHOSPITAL
Page 179 and 180: •• 'HISTORY NO. diRIRXL IXXMI l
Page 185 and 186: ~~J2ITTIGN OF CODES (Co~~i~ued) FCa
Page 187 and 188: DEFINITION OF CODES (Continued) FOF
Page 189 and 190: DEF~~ION OF CODES (Continued) PELVI
Page 191 and 192: DEFTIHTION OF CODES (Continued) FQR
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ZEFT1ITTIO:i OF CODES (Con"'c:..!!U
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DEFINITION OF CODES ( Con~inued) FC
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:t , I~ I ~ It II! I~ ::: .. ~ .. ~
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!:: llil\41.0 ~ ~~ ~'~"'~ -N OB-9 -
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PRENATAL RECORD (Con 1 t) PRESENT P
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PRENATAL RECORD (Con 't) complete a
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PRENATAL RECORD (Can't) EVALUATION
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PRENATAL RECORD (Con't) GENERAL IDl
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OB-42 Past Medical History Form OB-
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-· eoL"-aooa-..a 08-42 PAST MEDICA
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Instruction Manual for Obstetric Fo
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OB-43 Initial Prenatal Examination
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COL ..-3008-41 UIIYe 10.U) 1. PATIE
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DEFINITION OF CODES miTIAL PRENATAL
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DEFINITION OF CODES (Continued) FOB
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DEF'INITION OF CODES (Continued) FO
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I ,rnrn:r s YIN.Ct:l S6¥:;~rn I
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I, I'ATIENT IDENTI,.ICATIDN OB-43 I
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OB-10 Return Visit and Laboratory R
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DEFTIUTION OF CODES (Continued) FOR
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DEFINITION OF CODES (Continued) FOB
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4/16/61 OB-10 RETURN VISIT AND LAB
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~"........ ,... ~,_~.a., RETURN VIS
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OB-44 Prenatal Observations Form OB
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..... C:Ol..llt-IOOa-44 1. PATIENT
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:FDRMS 03-10 DEFINITION OF CODES (C
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DEFINITION OF CODES (Continued) ~·
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Instructional Manual for Obstetric
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OB-45 Laboratory Record Form OB-45
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DEFllUTION OF CODES LABJRATORY RECO
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DEFJNITION OF CODES (continued) FIE
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DEFINITION OF CODES (continued) FOR
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DEFINITIDN OF CODES (continued) FOR
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DEFTIUTION OF CODES (continued) FOR
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DEFINITION OF CODES (continued) FIE
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DEFINITION OF CODES (continuted) FI
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DEFTIHTION OF CODES (continued) FIE
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DEFTIUTION OF CODES (continued) FIE
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OB-11 Record of Current Pregnancy F
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CO~A·3C03·11 lltEV. '7·58 I. PAT
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RECORD OF CURRENT PREGNANCY (For Fo
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,... RECORD OF CURRENT PREGNANCY IN
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OB-46 Physician•s Clinic Record,
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COLR-1001-4e 4-a I. PATIENT IDENTII
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Instruction :\l:J.nual for Obstetri
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OB-12 Summary of Hospitalization fo
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SUMMARY OF HOSPITALIZATION FOR ANY
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SUMMARY OF HOSPITALIZATION FOR ANY
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':.::-•••suMMARY OF HOSPITALI
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OB-47 Summary of Antepartum Hospita
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· COLIII-IOOa..7 (CHANGIED 2-8a)
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OB-15 Drugs in Pregnancy Form OB-15
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PH S.300S.18 ..... PATIENT IDENTIFI
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.... PMS•3003•18 PATIENT IDENTI
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PHI·IOOI .. 1B P"TIENT IOENTIFIC"T
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PATI~NT IDENTIFICATION OB-15 DRUGS
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..... PHS .. 3003 ... 11 PATII!NT I
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DEFINITION OF CODES DRUGS lN PREGN
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Drugs in Pregnancy (08-15) Blank 0
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Drugs in Pregnancy (cont.} 2128 Par
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Orugs in Pregnancy (cont.) 4256 Hyo
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. Drugs in Pregnancy (cont.) 7154 S
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1 Drugs in Pregnancy (cont.) 7482 O
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Drugs in Pregnancy (cont.) 9169 917
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Drugs in Pregnancy (cont.) 9949 995
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Prenatal Record - National Archives and Records Administration

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