Prenatal Record - National Archives and Records Administration

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Reproduced at the National Archives 1-1 1-1 >• ..... U1 1\.) @ I 1.0 Data Ite~s Referenr.lnQ form ~B-9, Pren~tAl Recor~ OATil TTF.M l't'E~~' JN CARO 10 F'JIUt NUM FROM TO OATil TTF:M NAME &57 ••• oR-" 1 4309 22 '2 Eves, othPr abnor~alttv r,o;e ••• oR-9 2 4)0Q 21 23 Mouth: ~ent~l cArtes 6'59 ••• 01~-9 2 4309 24 24 Mouth: tePtM ~irty 660 ••• 013•9 2 4309 25 25 Mnuth: tepth mlsstn~, ~anv 6fil ••• oR-9 2 430CJ 2fi 26 Mouth: e1entulous 6fi2 ••• 0R•9 2 430Q 27 27 Mouth, nther Abnor~alttv 6~3 ••• 0R•9 3 430Q 2A 28 RPsPlratory tract, uoner; oharynx inflammation 6fi4 ••• 0R•Q 3 430Q 29 29 RPsoiratory tract, uooer: oreath soun~s ahnorMal 665 ••• oR-9 3 430CJ )I) 30 RPsPiratorv tract, uooer; rates 666 ••• 0R•9 3 4]0Q 3t 11 RPsotratorv traet, uooer: ~roans; wheezes 6&7 •••0R•9 3 UO" 32 12 RPSDiratorv traet, upoer, 3t.ner abnormality 61\I ••• OA•Il 4 noca )1 33 ~V~Ph nodPs en1ar1ed locallY 6f\9 ••• DR•Il 4 4)0Q 34 14 ~v•oh nodes enlar3e~ ~enerallv &7o ••• oR-Q 4 410CJ 3!'i 35 Ly~oh nodPs, other abnor~alftv 67l ••• DR•9 5 4lOQ 3fi 36 Thyroid enlarQe~ent, ~eneralize1 672 ••• 0A•9 5 noca 37 37 Thyroid enlarqe~. one lobe 67J ••• OA•9 5 4]0Q ]A lA Thvrofd, solitary no1u1e 674 ••• DR•9 5 4309 )Q ~9 T~vrofd, other abnor•alltv 675 ••• 0R•9 6 430Q 41'1 40 H~art •urMur 676 ••• 0A•Il 6 430Q 41 41 Heart rhythM, lrre~ular 677 ••• oR-ca b 430Q ., 42 H~art, nther abnor•allty 67B ••• OR·9 7 430Q 43 43 Breasts: oaloable •ass 679 ••• oR-Q 1 4309 44 44 BreAsts, ~t~er abnor~alftv 6AO ••• OA•Il 8 4100 411\ 45 RreAsts~ ntooJes, tnverte1 61H ••• OR•Q 8 430Q 46 4& Areasts~ ninole~, fissured 6A2 ••• 0R•9 R 4109 47 47 Breasts: ntooles, other a~~or~alitv 6Al ••• OR•9 9 4309 4A 48 Ah1omPn, oaloable or~an or ~ass 6A4 ••• 0R•9 9 4309 4Q 49 Ah~omen, oo~ratfve scar &As ••• oR-Q 9 4)09 50 o;o 1\hjomen, hernia 6A6 ••• 0R•9 9 430Q !)1 51 AbjomPn, other abnormalftv 6A7 • • .Of~-9 10 HOCJ 5' ~2 F.xtremitv: e~ema 6A8 ••• 0R•Q 10 4109 53 '53 ~xtremttv: vartcosftles 699 ••• 0R•Q 10 410CJ 54 ~4 ~xtre~ity, other abnor~alfty 690 ••• 013-CJ 11 4309 55 55 orthonedlc defect 69l ••• oR-'l t' 430Q 56 '56 Skin: 1aun~tce 57 Skin; 692 ••• 0R•9 693 ••• 0R•9 694 ••• oR-" 12 12 12 4309 4309 4309 57 SP SQ ~8 S~in: rash lPsfon other ahnor~alltv 59 S~ln, 695 ••• 0R•9 11 4109 60 ~0 Ahnorma11t1Ps, other svste•s 6CJ6 ••• 0R•9 4309 61 61 E~it co~e 697 ••••••• 4309 62 RO Blank 49A7 •••• VAR 5'5 56 Prenatal visits, total nuMb~r 49«J5 •••• VAR b Rt R2 Hetoht fin)
Reproduced at the National Archives nata Items RPterenclnQ Form oar11 TrF.Iil 1TE14 JN CARfl TO F'JPiil NIIM 4996 •••• VAR 4 49«H •••• VAR 4 521D •••• VAR 25 5217 •••• VAR 3 5219 •••• YAR 5248 •••• YAR 3 9-17 nR-9, Prenet~l FRO~ TO 81 fl5 86 88 ]JQ 319 32Q Ht ]34 316 l8A lAB Recnr~ !)l'fA T fEM NAM F. WeiC!ht, ore oreQnencv (lbs) Wf'laht aafn ( 1 bS) Pelvic su~matlon, Inlet Blood pressurP, ·svsto lie, ftrst recorie~ Blond oressure, :Uastolfc, first recorded Premature: htrt~s, total nu~bf'r orlor to current preQnancv '\ H H > • ~ l11 UJ ~ ~
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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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Page 29 and 30:
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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Page 51 and 52:
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
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ILL..'1ESS OR DISABILITY CODES (Con
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RECENT MEDICAL HISTORY (Con 1 t) OB
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OB-6 Past Medical History Form OB-6
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z PAST MEDICAL HISTORY (Interviewer
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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 129 and 130: Reproduced at the National Archives
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 and 154: OB-8 Repeat Prenatal History Form O
Page 157 and 158: I. ftATIIMT IDfNTIPICATIOM REPEAT P
Page 161 and 162: DEFINITION OF CODES (Continued) FOR
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 173: Reproduced at the National Archives
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
Page 205 and 206: :t , I~ I ~ It II! I~ ::: .. ~ .. ~
Page 207 and 208: !:: llil\41.0 ~ ~~ ~'~"'~ -N OB-9 -
Page 209 and 210: PRENATAL RECORD (Con 1 t) PRESENT P
Page 211 and 212: PRENATAL RECORD (Con 't) complete a
Page 213 and 214: PRENATAL RECORD (Can't) EVALUATION
Page 215 and 216: PRENATAL RECORD (Con't) GENERAL IDl
Page 217 and 218: OB-42 Past Medical History Form OB-
Page 221 and 222: -· 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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