Date |
|
2021-06-16
|
Study ID |
|
PT-102
|
Date subject signed consent |
|
2012-08-28
|
Upload the patient's consent form |
|
Consent.docx
|
First Name |
|
Eland
|
Last Name |
|
Venture
|
Street, City, State, ZIP |
|
Venture Keep, Luthadel, Central Dominance, 11235
|
Phone number |
|
(435) 879-4343
|
E-mail |
|
VentureHeir@Venture.com
|
Date of birth |
|
1985-08-08
|
Age (years) |
|
30
|
Sex |
|
1
|
Has the patient given birth before? |
|
|
Gym |
|
Tuesday,Thursday
|
Aerobics |
|
Friday,Monday,Wednesday
|
Smoke |
|
|
Drink (Alcoholic Beverages) |
|
Friday
|
Specify the patient's mood |
|
56
|
Is patient taking any of the following medications? (check all that apply) |
|
Zoloft
|
Height (cm) |
|
177.8
|
Weight (kilograms) |
|
70
|
BMI |
|
22.1
|
Comments |
|
Very cooperative
|
participant_id |
|
|
Test Field 1 |
|
|
Test Field 2 |
|
|
DSRowId |
|
1742
|
Di Import Hash |
|
C+5mPt+5ZVqq9DcgIo3DSg==
|
Day |
|
44361
|
Dataset Id |
|
1
|
|
Date |
|
2021-06-16
|
Emergency Contact Phone Number |
|
(556) 254-3691
|
Next of Kin Contact Name |
|
Vin Venture
|
Next of Kin Contact Address |
|
The Mist
|
Next of Kin Contact Phone Number |
|
(556) 254-3691
|
DSRowId |
|
1742
|
Di Import Hash |
|
UlNBOqEfEI/oa4Oaur3shw==
|
Day |
|
44361
|
Dataset Id |
|
2
|
|
Date |
|
2021-06-16
|
Serum Prealbumin (mg/dL) |
|
74.0
|
Creatinine (mg/dL) |
|
98.0
|
Normalized Protein Catabolic Rate (g/kg/d) |
|
12.0
|
Cholesterol (mg/dL) |
|
55.0
|
Transferrin (mg/dL) |
|
45.0
|
DSRowId |
|
1742
|
Di Import Hash |
|
VE+486lhaNuCWiKsvYQp/w==
|
Day |
|
44361
|
Dataset Id |
|
3
|
|