Date |
|
2021-06-16
|
Study ID |
|
PT-103
|
Date subject signed consent |
|
2009-10-15
|
Upload the patient's consent form |
|
|
First Name |
|
Paul
|
Last Name |
|
Atreides
|
Street, City, State, ZIP |
|
Arakis
|
Phone number |
|
|
E-mail |
|
SpiceFlow@Arakis.net
|
Date of birth |
|
1965-01-05
|
Age (years) |
|
52
|
Sex |
|
1
|
Has the patient given birth before? |
|
|
Gym |
|
Friday,Tuesday,Monday,Thursday,Wednesday
|
Aerobics |
|
Thursday,Friday,Monday,Tuesday,Wednesday
|
Smoke |
|
Wednesday,Monday,Friday
|
Drink (Alcoholic Beverages) |
|
|
Specify the patient's mood |
|
76
|
Is patient taking any of the following medications? (check all that apply) |
|
Prozac
|
Height (cm) |
|
175.0
|
Weight (kilograms) |
|
66
|
BMI |
|
21.6
|
Comments |
|
Strange Blue eyes
|
participant_id |
|
|
Test Field 1 |
|
100
|
Test Field 2 |
|
100
|
DSRowId |
|
1743
|
Di Import Hash |
|
8r6T2SL8+eGQbC/NsZtA/Q==
|
Day |
|
44361
|
Dataset Id |
|
1
|
|
Date |
|
2021-06-16
|
Emergency Contact Phone Number |
|
|
Next of Kin Contact Name |
|
Irulan Corrino
|
Next of Kin Contact Address |
|
House Corrino
|
Next of Kin Contact Phone Number |
|
|
DSRowId |
|
1743
|
Di Import Hash |
|
/T+AQhMTa/3ntxr4wE17zw==
|
Day |
|
44361
|
Dataset Id |
|
2
|
|
Date |
|
2021-06-16
|
Serum Prealbumin (mg/dL) |
|
64.0
|
Creatinine (mg/dL) |
|
82.0
|
Normalized Protein Catabolic Rate (g/kg/d) |
|
6.0
|
Cholesterol (mg/dL) |
|
50.0
|
Transferrin (mg/dL) |
|
34.0
|
DSRowId |
|
1743
|
Di Import Hash |
|
fRG/ct8/hRJYLRgf2QY6Ng==
|
Day |
|
44361
|
Dataset Id |
|
3
|
|