Prenatal Record - National Archives and Records Administration

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PHS.300!o.1S !S .5! PATII!NT IDIENTII"ICATION 08-15 DRUGS IN PREGNANCY- IX CODE A· TAKEN 1 DAY ONLY I· TAKEN 1-7 DAYS C- TAKEN MORE THAN 7 DA\'S D- TAKEN UNKNOWN TIME MISCELLANEOUS DRUGS (cardiac, ":'""::' uterotonic, cough medicine, vitamin K, ~llf-'---r-""'I'T"'"--rr-~-r--T'!r---TT--rr--rr---rr--rr-"TT"""""'"l odo yllin-c:ontaining ·1 9500 Alevaire ••••••••••••••••• , , , , , , • • 0 9102 Bony lin •••••• • • • • • • • • • • • • • • • • • • • • 0 9905 Carter's Little Liver Pills , ••• , •• , • , • • • 0 9905 Cascara sagrada •••• • • •• • • • • • • • • • • • • 9103 Choracol ••••••••••••••• , • , • , • , , • • 0 9105 Colban cough medicine ••• • • • • • • • • • • • • D 9905 Compouncl caacara tabs .......... • • • • • • • 0 9001 digitalis ••• , •••• • •• • • • • • • • • • • • • • • D 9002 digitoxin ••••• • • • • • • • • • • • • • • • • • • • • 0 9109 Endatusain ••••••• • • • • • • • • • • • • • • • • D 9050 heparin •••••••••••••• • • • • • • • • • • • • D 9905 Hinkle's pill a , •• , , ••••••• • •••• , • • • 0 9106 Pertuaain , • , , ••••••••• • • • ••••• • • • 0 9402 Pitacin ••••••••••••• • • • • • • • • • • • • • 0 9107 Pyraldin ••••••••••• • • • • • • • • • • • • • • D 9104 Robituaaln••••••••• • •• • • • • • • • • • • • • D 9403 Sparteine sulfate (Spartocin) ••••••••• • • • D 9401 Syntocinon •••••••••• • • • • • • • • • • • • • 9101 Terpin Hydrate (elixir), ••• • •• • • • • • • • • • 0 9403 Tocoaamine ••••••••••• • • • • • • • • • • • • 0 9108 Tuaoaminic ••••• • • ••• • • • • • • • • • • • • • 0 9901 Vitamin K (Menadione) •••• • •••••••• • • • 0 ~~.-~ ~~~~:!...................-- D ~:':e: ~~~~:!..................... D DIIJIIAftTM&NT orr HIIAL.TH. t!:OUCATION ANIO W.LfiAa. PU •L.IC HEAL. TH SCIItV1C& DDDDDDDDDDDD 1BBBBBBBBBBBB !DDODDDDDDDDD iDDDDDDDDDDDD 5DDDDDDDDDDDD ~DDODDDDDDDDD ~DDODDDDDDDDD lDDDDDDDDDDDD DODDDDDDDDDD DDODDDDDDDDD DDODDDDDDDDD DDODDDDDDDDD DDDDDDDDDDDD DDDDDDDDDDDD .DDDDDDDDDDDD lDDDDDDDDDDDD ~DDDDDDDDDDDD iDDODDDDDDDDD iDDODDDDDDDDD $DDDDDDDDDDDD 1DDDDDDDDDDDD lDDDDDDDDDDDD lDDDDDDDDDDDD .... II.A.360 OB-15 Reproduced at the National Archives
Reproduced at the National Archives H Ḥ )I . Form Item Nulllbers 11nlced to n11ta ltPIIIS on o~-15, nru1!l t n Pre!lni!lncv I TEN OATA ON JrF.N CARO FOR14 10 NUM FRO Ill TO DAtA IrF.N NANF. 796 •• 0A•t5 797 •• ()A•15 1106 •• 01'•15 0315 031~ 30 31 40 30 Jt 40 oruq Orun Orua nth, nth, nth, 4 wlcs. or tor to .lmo lUnflr 11ontn of oreqnancy lUnflr ,.,ntn of oreqnancy 1 031'5 to 807 •• 0~·15 031'5 41 41 Drua nth, lun~tr •onth of Drf'Qruncy H or more 79R •• OA•t5 0315 3?. 'l2 orua f'lth, lunar 'llnntn of oreqnaf'lcy 2 79CJ •• OR•t5 o:us H JJ orua f'lth, lllnflr 'llontt'i of oreqnancv ] IIOO •• OA•15 031'5 34 14 OTUIJ ntt'l, lnn~tr IIIOnth of' orP.:Jnancv 4 1101 •• 01'•15 031"i 3'5 :l5 Oruo ntl't, lunar •onth of oreq.,ancy '5 II02 •• 0A•15 AOJ •• os-t5 Ol1"i 36 J6 oruq 031'5 37 J7 oruq nth, nth, lunar lunar •onth of 111ontn of oreql"'ancv orPqnancy 6 7 A04 •• 0A•15 031'5 n l8 orua nth, lllnflr 111ontn of oreCJnancv 8 ROS •• OA•15 0~1"i H 'l9 orua nth, lunar 'IIOnth of oreqnal"'cV q AOfi •• OA•t5 79"i •• OA•15 031'5 47 42 OJl"i 26 79 orua oruq "th, lun~tr 'llonth ot orP.qnancv unknown ntl't, nltllll" 623n •••• w-4 10 13 oruct, actfVf' COIIIPOUnd, code 6231 •••• w-4 14 14 Orua, arttve eompound, use frequency, 6732 •••• w-4 15 15 Druq, active co111oounc1, use frequency, &241 •••• w-4 24 74 orun, IIC"ttve COIIIOOUf'ld, liSP. freqnel"'cy, &24?. •••• 111-4 2"i 75 orua, aC'tiVI" COIIIoOUnd, use frP.quency, four weeki prior to LMP lunar month of oreqnancy, lun'lr 111ontn of oreanaf'lcy, lun~tr montl\ of ori"Qnancv, w olus 0'1 .... 6233 •••• w-4 16 16 oruo, active compound, use frequency, 6234 •••• 11-4 17 17 oruCJ, act1Vf' COIIIDOUnd, liSP. frequency, lunar lunar 111ontn month of of oreqnancy, preqnancy, 2 3 6235 •••• 111•4 111 '8 b236 •••• w-4 1CJ 19 orua, Orua, acttve acttve co'llpound, use frequency, lunar month of COIIIDOUnt:l, use fre~uency, l1Jnl'.lr 111ontn of oreqnancy, oreqnancy, 4 5 6237 •••• 1111-4 20 ?.0 oruct, active co'llooun:t, use frequ~ncv, lunar •onth of oreqnancy, b 6238 •••• w-4 21 ?1 Orua, acttvl" COlli POUnd, liS@ frP.quencv, lunar IIOnth of oreqnancy, 7 6239 •••• 111-4 21. ?2 orua, a~tlve compound, use fr@quencv, lunar 11onth of preqf'lancy, 8 6240 •••• 111-4 2) 23 orua, ltC'tiV@ C'OIIIOOUnd, use frequency, lunar 11101\th of preqf'lancy, 9 6?41 •••• 111-4 26 ?6 orua, acttvP comoound, l1S@ fre~llency, lunl'.lr 11onth of oreqnancy, unlenow" 6214 •••• 1i•3 10 13 orua, trarte na111e, co::le &22J •••• w•3 22 22 621S •••• w-3 14 14 orua, Drua, trade trade name, use freqeuncy, lunar 111onth of pregnancy, 9 name, use frequency, fonr weeles prtor to L.. P 6216 •••• 111•3 1"i 15 Orua, tratte name, use freauenev, lunar 111ontn of pregnancy, 1 622S •••• w-3 24 ?.4 oruo, trade n~tme, use frenuency, lunar month of oreqnancy, tO b126 •••• il-3 2"i 75 orua, tra1e n~tmf!, use freauency, lunar lllol"'th of oreanancy, t1 plus Q 6217 •••• N-3 16 1b Orua, trat1e nRIRe, use fre!luP.ncv, lul\ar month nf oreqnancy, ?. I .... 6219 •••• N•l l11 621CJ •••• w-3 622o •••• w-3 6221 •••• w-3 &227 •••• 111•3 17 1~ 1Q 20 21 17 18 19 20 71 oru11, orua, Drua, oruo, orua, trat1e trade tral1e trar'le trar'le na111e, na111e, name, na11e, nl'.l'lle, use use use use use frequency, freauency, frequency, frequf'ncy, tren
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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
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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
Page 331 and 332: 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: ..... PHS .. 3003 ... 11 PATII!NT I
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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