Prenatal Record - National Archives and Records Administration

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Reproduced at the National Archives -- LAEORATORY RECORD FORMS OB-10 und OB-45 ~~~ o.:»-CO•J 1 7 1- t----..-21-.- ~ ~"11""-,To-.-.-., 11 ••fs 1- I~ URINAL VSIS flRSI SECOtij) THIRD I i.MT&! IMTi ~~~e ICM.P • 1-1 1-1 >• w 1- ..... 8 YINJ)8. I 43tS" i li N ,_ =~ ~ 1- I lir-1 ~3di ~ = ~ Cl ~ ~iii u l1ili - ~ ~ c al,\J iii It__!___!____!)~~~- • ' 10 11 12 11 !iM" •lla• ~tl~nMnl7~2~~~ •••In * Item numbers rere:r to OB-45 dated: 4(62. ** Additional card u} requirea if mre h!Ul 5 Urinulyses. lij S6 sisa-stii~4 n FOURTH )ATEi l~lli ~ i ~ l.ul-f"'~!OJ I J! 1(.1~~·~ 1slls• FIFTH 1111111 I ~ .8LANt( IUju, ''' n 11 7t 111 @ I ~ Ul
Reproduced at the National Archives LABORATORY RECORD FORMS OB-10 and OB-1~5 ~·-4' - o..:l -'o'~ B -:~. 'I II 1.;;1 I- X~ m--.- 'J I' 1011121JI411HUl llt:ID21222l242Sl6 Jli19Jiii"l2nlils1ilfli3H0414HH4 S4HI~19!0SIS2 lii1n& ,~... 16UUUHU16U9l01fi2nJ41SI6J1JI1t10 1- I X-RAY PELVIMETRY ~p SMIAR ~iSISilll&:S H H 0 tJj ~--~- DATE I~ PElVIC MEASUREMEI\ltS I Z !! :INl.&T MID PElVIS OUTLI:T ~ 1-- ~~~r--;r--T--~--~~~~,__, ~ CARD NIND.B*- J II) w 4 ~ ~ ; ~4!i ~ >• ' .. ~ . Cl .., w -- ~ c c ..... i I "' ~ Ill Ill w 7 e - :1 ~ '2 ... 2 .... -- ! I- • I; II '~ ~ L ~ .. ~ I! 0. ~ ~ 1 E J\ ,. !li :) c ,.. < t- c c: t- o. ' i u I 2 3 4 \ 6 1 I 9 10 II 12 131411~ ~ II I It :10 2 n 242S 2< 11 21 :II 30 31 3 1330 36 ll J 3940 4 U 0 4 4S4HI I fl SO Sl S S354SH6SI S1 S '" U U ~~ 6UJ6U16Ut lO JIJ2 JJ JHSJUJJIJt. * Item numbers refer to OB-45 dated: 4/62.. DATE J)AT£ ~ I!; I~ ,_ 13 ~ • 1121~ ~ ~I~ 3 ~ : ~~~~ c " ~e~ e A .,. 110 1 ::~ ~ .BlANK ~ l11
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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
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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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~~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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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
Page 283 and 284: Reproduced at the National Archives
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 293 and 294: DEFINITION OF CODES (Continued) FIE
Page 295 and 296: Instructional Manual for Obstetric
Page 297 and 298: OB-45 Laboratory Record Form OB-45
Page 313 and 314: DEFllUTION OF CODES LABJRATORY RECO
Page 315 and 316: DEFJNITION OF CODES (continued) FIE
Page 317 and 318: DEFINITION OF CODES (continued) FOR
Page 319 and 320: DEFINITIDN OF CODES (continued) FOR
Page 321 and 322: DEFTIUTION OF CODES (continued) FOR
Page 323 and 324: DEFINITION OF CODES (continued) FIE
Page 325 and 326: DEFINITION OF CODES (continuted) FI
Page 327 and 328: DEFTIHTION OF CODES (continued) FIE
Page 329 and 330: DEFTIUTION OF CODES (continued) FIE
Page 333: Reproduced at the National Archives
Page 339 and 340: Instruction Manual for Obstetric Fo
Page 341 and 342: OB-11 Record of Current Pregnancy F
Page 343 and 344: CO~A·3C03·11 lltEV. '7·58 I. PAT
Page 345 and 346: RECORD OF CURRENT PREGNANCY (For Fo
Page 347 and 348: ,... RECORD OF CURRENT PREGNANCY IN
Page 349 and 350: OB-46 Physician•s Clinic Record,
Page 351 and 352: COLR-1001-4e 4-a I. PATIENT IDENTII
Page 353 and 354: Instruction :\l:J.nual for Obstetri
Page 355 and 356: OB-12 Summary of Hospitalization fo
Page 357 and 358: SUMMARY OF HOSPITALIZATION FOR ANY
Page 359 and 360: SUMMARY OF HOSPITALIZATION FOR ANY
Page 361 and 362: ':.::-•••suMMARY OF HOSPITALI
Page 363 and 364: OB-47 Summary of Antepartum Hospita
Page 365 and 366: · COLIII-IOOa..7 (CHANGIED 2-8a)
Page 367 and 368: Instruction Manual for Obstetric Fo
Page 369 and 370: OB-15 Drugs in Pregnancy Form OB-15
Page 373 and 374: PH S.300S.18 ..... PATIENT IDENTIFI
Page 375 and 376: .... PMS•3003•18 PATIENT IDENTI
Page 377 and 378: PHI·IOOI .. 1B P"TIENT IOENTIFIC"T
Page 379 and 380: PATI~NT IDENTIFICATION OB-15 DRUGS
Page 381 and 382: ..... 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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