Date |
|
2021-06-16
|
Study ID |
|
PT-104
|
Date subject signed consent |
|
2011-06-04
|
Upload the patient's consent form |
|
|
First Name |
|
Katniss
|
Last Name |
|
Everdeen
|
Street, City, State, ZIP |
|
District 12
|
Phone number |
|
|
E-mail |
|
CaughtFire@panem.com
|
Date of birth |
|
1988-07-10
|
Age (years) |
|
27
|
Sex |
|
0
|
Has the patient given birth before? |
|
false
|
Gym |
|
Friday,Tuesday,Wednesday
|
Aerobics |
|
Thursday,Friday,Monday,Tuesday
|
Smoke |
|
|
Drink (Alcoholic Beverages) |
|
|
Specify the patient's mood |
|
20
|
Is patient taking any of the following medications? (check all that apply) |
|
Celexa,Prozac
|
Height (cm) |
|
144.0
|
Weight (kilograms) |
|
52
|
BMI |
|
25.1
|
Comments |
|
PTSD, Violent tendencies, abandonment issues
|
participant_id |
|
|
Test Field 1 |
|
|
Test Field 2 |
|
|
DSRowId |
|
1744
|
Di Import Hash |
|
3jaDaleA3BgisQPGBiNFSw==
|
Day |
|
44361
|
Dataset Id |
|
1
|
|
Date |
|
2021-06-16
|
Emergency Contact Phone Number |
|
(225) 755-2535
|
Next of Kin Contact Name |
|
Primrose Everdeen
|
Next of Kin Contact Address |
|
District 12
|
Next of Kin Contact Phone Number |
|
(225) 755-2535
|
DSRowId |
|
1744
|
Di Import Hash |
|
CXoAKpBi6vLcIeH14mrkqg==
|
Day |
|
44361
|
Dataset Id |
|
2
|
|
Date |
|
2021-06-16
|
Serum Prealbumin (mg/dL) |
|
59.0
|
Creatinine (mg/dL) |
|
51.0
|
Normalized Protein Catabolic Rate (g/kg/d) |
|
1.1
|
Cholesterol (mg/dL) |
|
40.0
|
Transferrin (mg/dL) |
|
41.0
|
DSRowId |
|
1744
|
Di Import Hash |
|
bbgVrayeZr7stIp+KQpWgw==
|
Day |
|
44361
|
Dataset Id |
|
3
|
|