Prenatal Record - National Archives and Records Administration

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IIICV. 7-•• Ill OBSTETRICAL ADMINISTRATIVE RICORD 1 1 ... TICNT IQCNTifi'ICATIOI'II )Pi" AL AK-1 r~ ..-· L Q ,..,,~,.. ,., ' ~.. ~ 'J" - ' .::.;,~ {.YLl~ t.. pt...._~ L-.) "' I PK>- ·~..., ~ -f ~.. -~ 'i~~~.~ ... CtJi./f,- }" 43 -1 a. L..AaT NAMC I. O~D NO. 4. HOI~ITA&. NO. 1. 8~CCIA&.. NO. e. II'UIIIT NAMC 7 ....DDI.C a.MAIDIIN 1 1 C:OIIIPL!TI 0111.Y I I IP ,_IDID IY I I HOSPITAL O. AODIIIIII (-·-10-1 ICily,;~;--•-• 10. TCLC~HONC NO. 11. KDC ••• DATK IIIIIIITKIIIID I"· OATil I'OIIM tNITIATJ ........T DAY ...... 18. DATC OP' .IIIlTH ....... I ~ :-~~ ~~-~~ ~~-~~ ~ I Dey : Y•• I I I I I I I I I I I I I I I I I I I I 17. MAfiiiiTAL ITATUI ......c. te. W'C&Ka 0~ 0 s OM OCL 0• Oo OsiP. 0• ON D• 0PR 0DtW I I I .. ' • • • • • ' • • o ...... _ Ocu... 9 ...... - 0"'- IIILIICTIIO 1'0,_ NOT IIILIICTIID ~1.. 20. ~ATICNT ITATUI 21 ..........." .............,.....,. 0 •.,.._.s-.1... 7 0..11• STUDY 1'0.-ITUOY ' • ....... s-.11..cs.-ilr) 0 (Specify .... Otloe< Mlowl ·-· • ....... ~ QUTATION I I ADDII~IAPH PLATI "-'CJ ....... 0 ..... CJ lillie CJ ..,..,. ...... ••aa•• CalllalleCJ ........ CJ aLuc CltOaa eltOUII NUM8CJt IB.UC ..II&LD ... CJ ICJ "CL.AT10....I....D MMIC OOCTOR RU •t~nloua ..Alii..CD N...., NIM-It N "'"IIVIOUIADDII._ u.s. a--•• "-ltlo, 1!......-. ........... P..WI• "-ltlt S..l.. (AR·l) II.A.l4 AR-1 Reproduced at the National Archives
-· IID'~7-- '·"'-- ':!e- ~ l·-~·:Ce. £'tC£fr 1-....+~ L OBSTITRICAL ADMINISTRATIVI a!CORD ......... _ S. _ ......... ......_ I ··---- - - I ~-';} ,_{:o ...i-r. (!ril-l) l OliO NO • ._~ALNO.. •• ...cJAI. NO. I 7 . ....... I I I COMPU'II ONLY I ,.,.___, I I I lf-IY I I HOIPIJAL .... ,__ ... aDa' tL DAft Rml18'1"at1D ! IS. DATa P'OIIII tNmA'I'I:D 14. f'tM'I" DAY UIP •• DA.ft 0/P aiiiTN ...... I I ' T- I lifo. I - I T- lifo. I I I ' T- lifo. I- I T- I I I I I I i I I I i i I ! I I -! I I t7. MARITAL. STATUS ... uc:. ••• WWIDC80P t- ~ATION I I 0 I D• oa. Ow OD o-. ow ON Do• 01'11 oo... I I a .. I I I .. I • • • I • Oaw. o- 0'• I z I --- -oiM_____ II.A.l5 AR-1 Reproduced at the National Archives
Page 1 and 2: NINCDS COLLABORATIVE PERINATAL PROJ
Page 3 and 4: NINCDS COLLABORATIVE PERINATAL PROJ
Page 5 and 6: INTRODUCTION DOCUMENT OBJECTIVES AN
Page 7 and 8: Forms The first forms used in the s
Page 9 and 10: Reproduced at the National Archives
Page 11 and 12: selection. A n1n was used for patie
Page 13 and 14: , researcher is more likely to look
Page 15 and 16: TABLE 3. Abbreviations for Person,
Page 17 and 18: TABLE 4. Definition of Person, Time
Page 19 and 20: TABLE 4. Definition of Person, Time
Page 21 and 22: CONTENTS AR-1/0B-1 OB-2 OB-3 OB
Page 23 and 24: AR-1 Obstetrical Administrative Rec
Page 29 and 30: DEFINITION OF CODES {Continued) FOR
Page 31 and 32: ... 1;:: I ~ .J.I'40JI.!9d jl5 !
Page 33 and 34: ADMINISTRATIVE RECORD MANUAL PHS-30
Page 35: ADMI!liSTRATIVE RECORD ;fl.A.TI.TUA
Page 39 and 40: OB-1: OBSTETRICAL· ADMINISTRATIVE
Page 41 and 42: Par. 3 10 - Religion. Record as Cat
Page 43 and 44: OB-2 Reproductive History Form OB-2
Page 47 and 48: COLIII:•IOoa-& ,.., REPRODUCTIVE
Page 51 and 52: DEFTIITTION OF CODES (Continued) FI
Page 53 and 54: 1 Reproduced at the National Archiv
Page 55 and 56: R~PRODUCTI\~ HISTORY (Con't.) C3-2
Page 57 and 58: REPRODUCTIVE HISTORY (Con•t.) C3-
Page 59 and 60: OB-3 History Since Last Menstrual P
Page 63 and 64: eoL"-aooa.a ACV. n-et • HISTORY S
Page 67 and 68: DEFINITION OF CODES (Continued) FOR
Page 69 and 70: DEFJNITION OF CODES (Continued) FOR
Page 71 and 72: "' 1: : ~~ :; "':J. !~ ~ ~ :~ ~ ; :
Page 73 and 74: HISTORY SINCE LAST 1-ENSTRUAL PERIO
Page 75 and 76: HISTORY SINCE ~T MENSTRQ~ P~RIOD {C
Page 77 and 78: OB-4 Gynecological History Form OB-
Page 81 and 82: COL.,.-aaaa-4 RIEV. tt-11 • GYNEC
Page 83 and 84: DEFINITION OF CODES GYNECOLOGICAL H
Page 85 and 86: DEFINITION OF CODES (Continued) FIE
Page 87 and 88:
'? I~ 1: :1\ j; t:: t; ....J 7 ,.
Page 89 and 90:
GY1~F..COLOGICAL HISTORY (Con't.) O
Page 91 and 92:
08-5 Recent Medical History Form 08
Page 93 and 94:
Reproduced at the National Archives
Page 95 and 96:
Page 97 and 98:
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 105 and 106:
Page 107 and 108:
ILL..'1ESS OR DISABILITY CODES (Con
Page 109 and 110:
Page 111 and 112:
RECENT MEDICAL HISTORY (Con 1 t) OB
Page 113 and 114:
OB-6 Past Medical History Form OB-6
Page 115 and 116:
Page 117 and 118:
z PAST MEDICAL HISTORY (Interviewer
Page 119 and 120:
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 129 and 130:
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 137 and 138:
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 155 and 156:
Page 157 and 158:
I. ftATIIMT IDfNTIPICATIOM REPEAT P
Page 159 and 160:
Page 161 and 162:
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 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
C:OL.II.·- I•It NU\E IHOSPITAL
Page 179 and 180:
•• 'HISTORY NO. diRIRXL IXXMI l
Page 181 and 182:
Page 183 and 184:
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 193 and 194:
Page 195 and 196:
ZEFT1ITTIO:i OF CODES (Con"'c:..!!U
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
DEFINITION OF CODES ( Con~inued) FC
Page 203 and 204:
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 219 and 220:
Page 221 and 222:
-· eoL"-aooa-..a 08-42 PAST MEDICA
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Instruction Manual for Obstetric Fo
Page 231 and 232:
OB-43 Initial Prenatal Examination
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
COL ..-3008-41 UIIYe 10.U) 1. PATIE
Page 239 and 240:
Page 241 and 242:
DEFINITION OF CODES miTIAL PRENATAL
Page 243 and 244:
Page 245 and 246:
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 253 and 254:
Page 255 and 256:
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 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
Page 271 and 272:
DEFTIUTION OF CODES (Continued) FOR
Page 273 and 274:
DEFINITION OF CODES (Continued) FOB
Page 275 and 276:
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 283 and 284:
Page 285 and 286:
..... C:Ol..llt-IOOa-44 1. PATIENT
Page 287 and 288:
Page 289 and 290:
:FDRMS 03-10 DEFINITION OF CODES (C
Page 291 and 292:
DEFINITION OF CODES (Continued) ~·
Page 293 and 294:
Page 295 and 296:
Instructional Manual for Obstetric
Page 297 and 298:
OB-45 Laboratory Record Form OB-45
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
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 331 and 332:
Page 333 and 334:
Page 335 and 336:
Page 337 and 338:
Page 339 and 340:
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:
Page 369 and 370:
OB-15 Drugs in Pregnancy Form OB-15
Page 371 and 372:
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
Page 383 and 384:
Page 385 and 386:
DEFINITION OF CODES DRUGS lN PREGN
Page 387 and 388:
Drugs in Pregnancy (08-15) Blank 0
Page 389 and 390:
Drugs in Pregnancy (cont.} 2128 Par
Page 391 and 392:
Orugs in Pregnancy (cont.) 4256 Hyo
Page 393 and 394:
. 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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