FormsPlayer has failed to load! Please check your installation XForm automatically generated from ODM Study Definition file:///usr/local/tomcat/apache-tomcat-5.5.17/webapps/XML4PharmaServer/temp/xform200721813045.2951.html F_BASELINE Test Subject system-generated M false 0 0 0 0 eCRF XForms example Courtesy of XML4Pharma Form: Baseline
Study Event ID
Group: Common Site number Must be an integer.
Subject ID
Visit Date Must be a valid date. Correct format is: yyyy-mm-dd
Visit Start Time Must be a valid time. Correct format is: hh:mm:ss
Group: Demographics Date of Birth Must be a valid date. Correct format is: yyyy-mm-dd
Sex Male M Female F
Race Caucasian CAUCASIAN Black BLACK Asian ASIAN Other OTHER
Group: Smoking History Check when the subject is a smoker Give "false" or "true"
Number of cigarettes per day Less Than 10 cigarettes per day LT10 10 to 20 cigarettes per day 10TO20 Greater Than 20 cigarettes per day GT20
Group: Drinking history Number of alcoholic drinks per day < 1 < 1 1-2 1-2 > 2 > 2
Group: Physical examination: Base Height The height value should be below 220 cm
Weight The weight value should be below 150 kg
Systolic BP The value should be below 180
Diastolic BP The value should be below 120
Does the subject feel dizzy when standing up from a sitting position No 0 Yes 1
Group: X-Ray Server or File location of X-Ray photograph Must be a valid URI or URL
Group: Complaints related to smoking Breathing No 0 Yes 1
Coughing No 0 Yes 1
Heart No 0 Yes 1
No. of illness days last year Must be an integer.Value must be lower than 1000
Number of bronchitis cases during the last year Must be an integer.Value must be lower than 100
Number of pneumonia cases last year Must be an integer.Value must be lower than 100
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