ID

2900

Description

Specimen Shipping Log - RF31 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE3BE7C-DD79-507C-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE3BE7C-DD79-507C-E034-0003BA12F5E7

Keywords

  1. 9/19/12 9/19/12 -
Uploaded on

September 19, 2012

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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Sarcoma, Kaposi xxx Transmittal - Specimen Shipping Log - RF31 - 2267315v3.0

No Instruction available.

  1. StudyEvent: Specimen Shipping Log - RF31
    1. No Instruction available.
Ccrr Module For Specimen Shipping Log - Rf31
Description

Ccrr Module For Specimen Shipping Log - Rf31

Fedex Tracking Number
Description

FedexTrackingNumber

Data type

text

Destination
Description

Destination

Data type

text

Date Shipped
Description

DateShipped

Data type

text

Patient ID#
Description

PatientID#

Data type

text

Initials
Description

Initials

Data type

text

Specimen Type
Description

SpecimenType

Data type

text

Purpose
Description

Purpose

Data type

text

Cycle/Week#
Description

Cycle/Week#

Data type

text

Time Drawn
Description

TimeDrawn

Data type

text

Date Drawn
Description

DateDrawn

Data type

text

Backup stored at local site?
Description

Backupstoredatlocalsite?

Data type

text

Condition upon arrival
Description

Conditionuponarrival

Data type

text

Name of person verifying contents
Description

Nameofpersonverifyingcontents

Data type

text

Name/phone number
Description

Name/phonenumber

Data type

text

Site name/fax number
Description

Sitename/faxnumber

Data type

text

Similar models

No Instruction available.

  1. StudyEvent: Specimen Shipping Log - RF31
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ccrr Module For Specimen Shipping Log - Rf31
FedexTrackingNumber
Item
Fedex Tracking Number
text
Destination
Item
Destination
text
DateShipped
Item
Date Shipped
text
PatientID#
Item
Patient ID#
text
Initials
Item
Initials
text
SpecimenType
Item
Specimen Type
text
Purpose
Item
Purpose
text
Cycle/Week#
Item
Cycle/Week#
text
TimeDrawn
Item
Time Drawn
text
DateDrawn
Item
Date Drawn
text
Item
Backup stored at local site?
text
Code List
Backup stored at local site?
CL Item
Yes (Yes)
CL Item
No (No)
Conditionuponarrival
Item
Condition upon arrival
text
Nameofpersonverifyingcontents
Item
Name of person verifying contents
text
Name/phonenumber
Item
Name/phone number
text
Sitename/faxnumber
Item
Site name/fax number
text

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