Prenatal Record - National Archives and Records Administration

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II.A.l32 OB-8 Reproduced at the National Archives
Reproduced at the National Archives H H • )II . ..... w @ I co Oat a Ite~s Referenetnq For~ na-o, ReDe~t Prer'lataJ •Hstnrv OAf A Tr~-. ITEM Olf CIIRO TO F'JR" NIIM FROM TO ()A fA TrF.M I'UJIIIIE 4A8••••••• 03011 t 5 Cl'lrd nu111ber (sequt"nee, for11 tvoe, for"' nu'llber, revlslon nu111ber> t99 ••••••• 0108 6 14 NTN08 CI'ISt" numbt"r 4qO ••• oA-II 4 OlOA 1'5 16 Form OB-8 d~tP ('110) 4CJ1 ••• 0R-A 4 0)09 17 t8 ror111 na-11 dl'ltt" (18y) 4CJ2 ••• 0R-II 4 0308 19 ?.0 For• ~B-8 date Cvr> 4CJ3 ••• 0R-II 6 03011 21 '21 stele fn any wav 4CJ4 ••• 0R-A 7 O~OA 22 ?2 H~'.ldachf' 4CJS ••• OR-A 8 03011 23 ?3 VIsual ,.lst•Jrhance 4Q6 ••• oR-A 9 03011 24 ?4 Wt>akness: numhnPss: :Hzztne!ls 4CJ7 ••• oR-fl 10 Q10A 25 ?5 Vl'l11ltfnq 4CJB ••• OR-P 11 03011 2fi ?6 Pain, ah:tomen, oelvts, bac< 4CJ9 ••• 0R-A 1?. 03011 27 ?1 Urlnarv urqen~v: 1ysurl"' 500 ••• oR-" 13 03011 2A ?A Ot'lrrhe~t sol ••• oR-11 14 01011 2CJ ?9 Cold: sou• throat: COIJQh S02 ••• 0R-II 15 OlOA ]0 JO revt>r SOl ••• OR-11 16 03011 lt H E:ve lnflam111at1on sn4 ••• oR-A 17 OJOA 32 32 Rash: skln r.on:Ht1on sos ••• oA-11 1(1 03011 H 'B J111un:tf ct" sn6 ••• oR-II ICJ 03011 ]4 34 Swollen qlan:ts so7 ••• oR-A 20 01011 3"\ 15 Co\1 sores SOB ••• oR-A 21 0308 36 36 Bolls: ab!:cesse:t teeth 509 ••• 0A-A 2?. OlOA J7 37 E~trache sto ••• oR-A 23 03011 ]A 18 Stt ••• OA-A 24 03()11 )Q 39 Swellfnn swellfntJ of tf'et or lf'qs nf h"'n1s or face 512 ••• 01\-A 25 0301! 40 40 Vaqtn"'l olefl'dfn1 Sfl ••• OR-8 26 01011 41 41 FllinttntJ 514 ••• 0R-A 27 03011 4? 42 Convulsions sts ••• oR-11 211 OJOA 41 43 AecfdPnt: polson: ln1urv 516 ••• 0R-A 29 030A 44 44 OPeration: surqerv 517 ••• 0R-II )0 01011 4S 45 Radiation: x-rav 51B ••• OA-R 31 01011 46 4b At r travel 519 ••• 0~-A 3?. 0308 47 47 In1ectlonJ var.clnl'ltt on 5?o ••• oJt-8 H 03011 48 48 Infl!ctious dl~e111se ln hO~I! 521 ••• 01\-R 34 0308 4CJ 49 Pfl>t in home, stele 5?2 ••• 0A-II ]S OlOA sn SO Wnr~ outsfdP home 523 ••• oR-8 36 03011 st "\2 Interco~rse frenuencv 5'24 ••••••• 030A 51 62 Rlanle 5?5 ••• os-fl 37 OJOA bl 64 SmokinCJ: claarettes, nu111ber per :lay 526 ••• 08-11 111 030R b5 65 ~,.:lfc~t1on taken s?7 ••• oR-fl 3CJ 03011 66 66 Phvslcl~n vtsfte:l 528 ••••••• 0308 67 AO Blank 49115 •••• VAII 17 52 53 s~olelno hlstorv: cl::tarettes Pl!r :lay now, nu•ber
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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
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08-5 Recent Medical History Form 08
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DEFINITION OF CODES RECENT MEDICAL
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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
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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 and 142: C:OLft-IOOa-7 1··· INFECTIOUS DI
Page 143 and 144: DEFINITION OF CODES nlFECTIOO'S DIS
Page 145 and 146: DEl''ll'IITION OF C:JDES ( Conti:::
Page 147 and 148: i i :a :: ·• 1: !: ! I! ::
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: 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
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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
Page 195 and 196: ZEFT1ITTIO:i OF CODES (Con"'c:..!!U
Page 201 and 202: 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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