Prenatal Record - National Archives and Records Administration

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II.A. 70 OB-5 Reproduced at the National Archives
Reproduced at the National Archives Data Items Referf'rtcin:J rorm OB-5, Recent 14eclfc~tl Htstorv D~U TrF:It ITEIII Jill C~HD 10 F'JQM NIIM FROM TO oara rrr.111 NUF: )04••••••• 1305 t 5 car-1 numbf'r (se11uence, forn tvoe, form number, revlslon numher) Jns ••••••• 110"i 6 14 NTNOB case number 3n& ••• oq-o; 5 130'5 1'5 16 Fnr~ na-s d~te ('10) 307 ••• oR-o; 5 130'5 17 18 Fnrm na-5 date ( :ja vl 309 ••• 0R-I\ 5 noo; tCI ?0 Fnrm 0B•5 dAte rvrl 309 ••• oR-5 130'5 2t 21 Illness or dlsabilltv, rea~frlna confinement, number 310 ••• 0R•"i 7 00'5 21. ?3 Illness or ~tsabllltv, rea~lrfna conffnf'ment, tvoe 31l ••• OR•'\ A llOI\ 24 15 Illness or ~lsabllltv, rea~lrtna conffnement, davs In bed 3t2 ••• oR-5 9 1305 26 27 Illness or t11sahllltv, rea~trtna ronftnement, date onset ('10) 3t1 ••• oR-'5 9 1'0'5 2~ 19 Illness or dtsabilltv, rea~tr!na confinement, date OF\Set (day) 314 ••• 01'\-"i 9 110'5 31'1 31 Illness or iisahllitv, reauirlna confinement, date onset (yr) 315 ••• 01\-"i tO DO"i 31 l2 Illness or ~tsabllttv, renutrtna confinement: ohvstclan consulted or nosoltaliz:ed 316 ••• 0R•"i 7 130'5 33 34 Illness or ilsanllltv, re11utrtna confinement, tVPf! 1-t 317 ••• oR-'5 9 130'5 l"i 16 Illness or dlsahllttv, reautrtn11 conflnf'ment, 1-t 3t9 ••• 0R·"i 9 nos 37 39 Illness or dlsanlllty, rea~trtna confinement, . )' 319 ••• oR-o; 9 130'5 H 40 Illness or dlsahllltv, reaufrtna confinement, ..... -..1 320 ••• 01"-'5 9 1305 41 42 Illness or dlsahllttv, reaulrtnn confinement, 31l ••• OP•"i tO 110'5 4l 43 Illness or ~tsabilitv, rea~irtna confineme'lt: or hosP1tal1ze1 322 ••• 0R•S 7 1l05 44 45 Illness or disability, re11uirin11 confinement, 311 ••• 01\-'5 8 00'5 46 47 Ill"ess or ~isabllitv, reautrtn1 confinement, 3?4 ••• oR-o; 9 110'5 4A 49 Illness or ~lsahilltv, reautrinq confinement, 325. o •')R•'i 9 no or; so "it Illness or rtlsabllitv, rea~irfnq conflnemf'nt, J?6 ••• oR-5 9 1105 5? '5) Illness or "lsanilitv, reaulrtna confinement, @ days ln bed date onset (110) date onset (dav> date onset (yr) onvsician consulted type days ln bed dat~ onset (:110) :jate onset Cdavl :late onset cvr> 3?7 ••• oR-5 10 130'i 54 54 Illness or ~~~abllttv, re1ufrtna confinement: ohvslcian consulte~ or noso1ta11Zed )?9••• 0R•5 1 1305 55 56 Illness 3?9 ••• oR-5 8 1305 57 58 Illness or or disabilltv, requtrina confineMent, type t1isabllitv, reaulrtn1 confinement, davs In bed 330 ••• 0R•'5 9 1305 SCJ 60 Illness or t1lsahilitv, reautrtna confinement, datf! onset (MO) 31t ••• oR-"i 9 130'5 6f 62 Illness or dlsabllttv, reaufrlna confinement, date onset Cdav> J32 ••• oR-'5 9 1305 63 64 Illness or t11sabilitv, reauirlna confinement, date_ onset cvn 313 ••• oR-5 10 00'5 6'5 65 Illness or rtisabiltty, reauirina confinement' ohvslcian consulted or hosoltal1ze
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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
Page 41 and 42: Par. 3 10 - Religion. Record as Cat
Page 43 and 44: OB-2 Reproductive History Form OB-2
Page 45 and 46: Reproduced at the National Archives
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: 08-5 Recent Medical History Form 08
Page 99 and 100: DEFINITION OF CODES RECENT MEDICAL
Page 101 and 102: DEl!'INITION OF CODES (Continued) F
Page 107 and 108: ILL..'1ESS OR DISABILITY CODES (Con
Page 111 and 112: RECENT MEDICAL HISTORY (Con 1 t) OB
Page 113 and 114: OB-6 Past Medical History Form OB-6
Page 117 and 118: z PAST MEDICAL HISTORY (Interviewer
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 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
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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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DEFINITION OF CODES (Continued) FOR
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DEFINITION OF CODES (Continued) FIE
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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
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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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