Prenatal Record - National Archives and Records Administration

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Reproduced at the National Archives H H • > • to.) .. 0 nata Ite~s Reterencina For~ UFI•10, Return Visit ~nd LAbnr~torv RecJrj OA ra Trl'.:" ITEM i) .. CARO Tl> fJQ" NIIM FRO .. TO OAfA TfF.M NAME 74o •• ns-1n 741 •• ns-1n 742 •• na-1o 743 •• 08•10 744 •• na-to 745 •• na-to 746 •• os-10 747 •• 08•10 748 •• 08•10 749 •• na-1n 750 •• 08•10 7!H •• 08•10 7"\2 •• 08•10 7 .. 1 •• ns-1o 754 •• 08•10 7"\5 •• 08•10 7t;6 •• os-1o 7';7 •• 08•10 7r;s •• no-10 7';9 •• 01\•10 760 •• 08•10 7fit •• na-1o 7fi2 •• 0B•10 7fi3 •• ns-to 7fi4 •• no-1f\ 71;5 •• 08•10 26 26 26 2fi 2fi 26 26 26 2f> 2f> 26 26 2fi 26 26 27-32 27-32 27-32 27·32 27-32 27·12 27•32 27•32 3310 3310 3110 3~10 3310 H10 3HO J110 HlO 3310 HlO ntn 3310 H10 3310 3310 3110 H1n 3310 H1n 3110 3310 JHO 3310 3311'1 3310 16 tA 1Q 20 21 n 24 25 2fi 27 2A )1'1 31 n 33 ]4 3f> 37 lfl 40 42 43 4'1 17 18 19 20 11 73 Seroloqy seroloay Serolnav seroloqy Seroloay Serolnav for for for for for for 24 seroloqy for ?5 seroloay for 16 seroloav for ?7 Seroloav for 19 30 SernlOQV seroloav for 31 12 33 15 ~6 37 19 41 42 44 45 4& 48 "iO sypntlfs, 1st svontlts, 1st svpnllts, 1st svonllis, 1st svontlts, 1st ~vonllfs, ?nrt ~yontlts, 2'lrt svonllts, 2nd svonl1ls, 1nd svont1ls, 2n1 (110) Cvr> result result result ('IIO) cvr> result result result for Syo~llls, 1r:.t svonllfs, 3rrt Cyr) C11o) seroloav for syohtlls, Jr1 seroloqv for svohllts, lrrt Seroln~y for syonllls, lrrt urtnatvsts, lst ('110) IJrlnalysis, Urinalvsts, Urinalysis, Urinalysis, Ur1nalys1s, Urtnatvsts, Urtnatysi~, urtn~tysts, Uri'lalv!115, 2n::l, 2n::l, Urin~ly~ts, Urinalvs15, 2n1, 1st (yr) lst, type lst, RBr. count 1st, IIBC count. lst, casts 2nd ('IIO) 2nd (yr) 27-32 46 tvoe 27-32 4., R~C count 27•12 4Q 766 •• ns-to 27-32 3310 51 '51 2nd, ~BC count casts 767 •• 08•10 27-32 HlO 52 '13 ur tnal ysiS, 3r:l (IIIOl 7fiB •• ns-tn 27-12 H10 54 '14 Urinalysis, 3r1 (Vrl 769 •• 08•10 27-32 3310 55 o;s urtnatvsis, 3rd, type 71o •• ns-1n 27-32 HlO 56 '17 Urlnatvsu, 3rd, RBC count 771 •• ns-10 27-32 331" 51! '19 Urinaly!lls, 3r::l, WBC count 112 •• ns-1n 27-32 3310 60 60 Urinalysis, 3r1, casts 773 •• ns-1n ]4 3310 &t 62 Urine culture (mol 774 •• ns-10 34 3310 63 63 Urine culture (yrl 775 •• ns-tn 34 3310 64 64 Urine culture result @ 17b •• nK-10 34 3310 fi"'i 66 I 777 •• nu-tn )4 3110 67 67 P"D Pao s"'e11r (1110) smear (yr) ....... 0 ns ..ne-10 )4 3310 6A 68 Pap s111ear result 779 •• nB-10 )4 3110 61) 69 Thvrofd tests 7flo •• nu-to 34 3HO 70 70 Rtood suqar: alueose toter!nee 7A1 •• 1'JB•10 35 3310 71 71 Blood type (father> 71!2 •• ns-ln 36 H10 1' 72 Rh tvoe (father) result result result test test test test test test test test test 1 2 3 1 2 3 1 2 3
Reproduced at the National Archives nata Items Referencln~ Form O~·tO, Return vts1t and J,aboratorv Pec~r:l D~U ITEIII TO 793 •• r'IB•10 7A4••••••• 49QB •••• VAR sono •••• vA~t 522t •••• vAq '52?5 •••• VAR o;2?& •••• vAq "2'-7 •••• vAq "i22B •••• VAR 41 24 H 20 25 21 24 23 TrF.114 Jtf F' JIU4 CARO """ 3310 331('1 FRO Ill H H 89 93 344 ]4-; Hf'i 147 35' TO 73 flO !Jt q5 344 345 346 3"i2 3-;9 !)~fA TTF:II4 N~ME H~t:Holollv: 'IC•T!IV, :ll!lc,nost ic RlaniC lfem11tocr1t lowest level, roercentl H~IIIOCJlOI"Iln, lOWPSt val uP (:trams) Blond tvpe COO!IIbS' tPst Rl'l factor H~m8tncr1t, date of lowf'st V!lllll" (mo/1av/vr> Htomoatobin, d~tl'! of lnw~st valu~ rmo/rtavtvr> 1-t 1-t > • N ~ ~ 0
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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 27 and 28:
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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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
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DEF'INli'ION OF CODES (Continued) F
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DEFINITION OF CODES (Continued) u.
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DEFINITION OF CODES (Continued) FOO
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PAST HEDICAL HISTORY (Con't) Item 1
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HISTORY TAKEN BY PAST MEDICAL HISTO
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OB-7 Infectious Disease and System
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COLIII.•I00 ..7 ,... INFECTIOUS D
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C:OLft-IOOa-7 1··· INFECTIOUS DI
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DEFINITION OF CODES nlFECTIOO'S DIS
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DEl''ll'IITION OF C:JDES ( Conti:::
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i i :a :: ·• 1: !: ! I! ::
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l!:i i!;T!IJIJ;: IIJ;;:..f,;:l·: .
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INF~TIOUS DIS~S~ ;~D SYSTEM REVIEW
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OB-8 Repeat Prenatal History Form O
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I. ftATIIMT IDfNTIPICATIOM REPEAT P
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~ :: : j: ~ : I~ =r ; Ia ~ ~ !~ ;
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,;.-~ 1•1. 1J;,.... - ~ .. u;W'o'
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OB-9 Prenatal Record Form OB-9, Pre
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C:OL.II.·- I•It NU\E IHOSPITAL
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•• 'HISTORY NO. diRIRXL IXXMI l
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Page 183 and 184:
Page 185 and 186:
~~J2ITTIGN OF CODES (Co~~i~ued) FCa
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DEFINITION OF CODES (Continued) FOF
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DEF~~ION OF CODES (Continued) PELVI
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DEFTIHTION OF CODES (Continued) FQR
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ZEFT1ITTIO:i OF CODES (Con"'c:..!!U
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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
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 219 and 220: Reproduced at the National Archives
Page 221 and 222: -· eoL"-aooa-..a 08-42 PAST MEDICA
Page 225 and 226: DEFINITION OF CODES (Continued) FIE
Page 227 and 228: DEFINITION OF CODES (Continued) FOR
Page 229 and 230: Instruction Manual for Obstetric Fo
Page 231 and 232: OB-43 Initial Prenatal Examination
Page 237 and 238: COL ..-3008-41 UIIYe 10.U) 1. PATIE
Page 241 and 242: DEFINITION OF CODES miTIAL PRENATAL
Page 243 and 244: DEFINITION OF CODES (Continued) FOR
Page 247 and 248: DEFINITION OF CODES (Continued) FOB
Page 249 and 250: DEF'INITION OF CODES (Continued) FO
Page 251 and 252: I ,rnrn:r s YIN.Ct:l S6¥:;~rn I
Page 257 and 258: I, I'ATIENT IDENTI,.ICATIDN OB-43 I
Page 259 and 260: OB-10 Return Visit and Laboratory R
Page 261: Reproduced at the National Archives
Page 271 and 272: DEFTIUTION OF CODES (Continued) FOR
Page 273 and 274: DEFINITION OF CODES (Continued) FOB
Page 277 and 278: 4/16/61 OB-10 RETURN VISIT AND LAB
Page 279 and 280: ~"........ ,... ~,_~.a., RETURN VIS
Page 281 and 282: OB-44 Prenatal Observations Form OB
Page 285 and 286: ..... C:Ol..llt-IOOa-44 1. PATIENT
Page 289 and 290: :FDRMS 03-10 DEFINITION OF CODES (C
Page 291 and 292: DEFINITION OF CODES (Continued) ~·
Page 295 and 296: Instructional Manual for Obstetric
Page 297 and 298: 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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Instruction Manual for Obstetric Fo
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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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Instruction Manual for Obstetric Fo
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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
Page 395 and 396:
1 Drugs in Pregnancy (cont.) 7482 O
Page 397 and 398:
Drugs in Pregnancy (cont.) 9169 917
Page 399 and 400:
Drugs in Pregnancy (cont.) 9949 995
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Prenatal Record - National Archives and Records Administration

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