Top Form | SARS_virus_investigation |
Style Sheet | |
Date Format | dd/MM/yyyy |
Text Colour | |
Text Field Background Colour | |
Form Background Colour | |
Button Background Colour | |
Selected Item Background Colour | |
Error Message Colour |
Name | Required | Type | Description | Constraints |
comments | No | String | None |
Name | Required | Type | Description | Constraints |
date_of_onset_of_illness | No | String | None | |
fever_more_than_38C | No | String |
| |
cough | No | String |
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myalgia | No | String |
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shortness_of_breath | No | String |
| |
diarrhoea | No | String |
| |
clinical_diagnosis | Yes | String |
| |
severity_of_illness | Yes | String |
| |
date_of_death | No | String | None |
Name | Required | Type | Description | Constraints |
contact_with_other_possible_patients | No | String |
| |
country_of_contact | No | String | None | |
place_of_contact | No | String | None | |
source_of_contact | No | String | None | |
type_of_contact | Yes | String |
| |
details | No | String | None |
Name | Required | Type | Description | Constraints |
name | No | String | None | |
city_or_town | No | String | None | |
fax_number | No | String | None | |
phone_number | No | List | None |
Name | Required | Type | Description | Constraints |
date_of_admission | No | String | None | |
admission_hospital | No | String | None | |
admission_ward_name | No | String | None | |
date_of_transfer | No | String | None | |
transfer_hospital | No | String | None | |
transfer_hospital_discharge | No | String | None |
Name | Required | Type | Description | Constraints |
chest_xray | No | String |
| |
xray_date | No | String | None | |
results | Yes | String |
| |
other_results | No | String | None | |
likely_diagnosis | No | String | None |
Name | Required | Type | Description | Constraints |
surname | No | String | None | |
first_name | No | String | None | |
date_of_birth | No | String | None | |
sex | Yes | String |
| |
country_of_residence | No | String | None | |
phone_number | No | List | None | |
occupation | No | String | None | |
address | No | String | None | |
city_or_town | No | String | None | |
post_code | No | String | None |
Name | Required | Type | Description | Constraints |
number | No | String | None |
Name | Required | Type | Description | Constraints |
name_of_reporter | No | String | None | |
report_date | No | String | None | |
organisation | No | String | None | |
phone_number | No | List | None |
Name | Required | Type | Description | Constraints |
patient_details | No | List | None | |
gp_contact_details | No | List | None | |
reporter_details | No | List | None | |
clinical_details | No | List | None | |
hospital_details | No | List | None | |
laboratory_results | No | List | None | |
contact_with_other_ill_persons | No | List | None | |
travel_history | No | List | None | |
additional_comments | No | List | None |
Name | Required | Type | Description | Constraints |
travelled_outside_UK | No | String | None | |
visited_area | No | List | None | |
return_date_to_UK | No | String | None | |
airport | No | String | None | |
symptomatic_on_flight | No | String |
| |
flight_details | No | String | None |
Name | Required | Type | Description | Constraints |
country | No | String | None | |
area | No | String | None |