Prenatal Record - National Archives and Records Administration

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