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Name
Label/Question

MONTH OF VISIT

Taken from: National Ambulatory Medical Care Survey, 1981.

YEAR OF VISIT

Taken from: National Ambulatory Medical Care Survey, 1981.

MONTH OF BIRTH

Taken from: National Ambulatory Medical Care Survey, 1981.

YEAR OF BIRTH

Taken from: National Ambulatory Medical Care Survey, 1981.

SEX

3. SEX

Taken from: National Ambulatory Medical Care Survey, 1981.

RACE

4. RACE

Taken from: National Ambulatory Medical Care Survey, 1981.

ETHNICITY

5. ETHNICITY

Taken from: National Ambulatory Medical Care Survey, 1981.

MOST IMPORTANT PROBLEM #1

6. PATIENT PROBLEMS: MOST IMPORTANT PROBLEM#1

Taken from: National Ambulatory Medical Care Survey, 1981.

MOST IMPORTANT PROBLEM #2

6. PATIENT PROBLEMS: MOST IMPORTANT PROBLEM#2 (IF ANY REPORTED)

Taken from: National Ambulatory Medical Care Survey, 1981.

OTHER PROBLEM

6. PATIENT PROBLEMS: OTHER PROBLEM

Taken from: National Ambulatory Medical Care Survey, 1981.

MAJOR REASON FOR THIS VISIT

7. MAJOR REASON FOR THIS VISIT

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSTIC SERVICES:NONE

8. DIAGNOSTIC SERVICES THIS VISIT: NONE

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:LIMITD HISTORY/EXAM

8. DIAGNOSTIC SERVICES THIS VISIT: LIMITED HISTORY/EXAM

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:GENERL HISTORY/EXAM

8. DIAGNOSTIC SERVICES THIS VISIT: GENERAL HISTORY/EXAM

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:PAP TEST

8. DIAGNOSTIC SERVICES THIS VISIT: PAP TEST

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:CLINICAL LAB. TEST

8. DIAGNOSTIC SERVICES THIS VISIT: CLINICAL LAB. TEST

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:X-RAY

8. DIAGNOSTIC SERVICES THIS VISIT: X-RAY

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:BLOOD PRES CHECK

8. DIAGNOSTIC SERVICES THIS VISIT: BLOOD PRESSURE CHECK

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:EKG

8. DIAGNOSTIC SERVICES THIS VISIT: EKG

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:VISION TEST

8. DIAGNOSTIC SERVICES THIS VISIT: VISION TEST

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:ENDOSCOPY

8. DIAGNOSTIC SERVICES THIS VISIT: ENDOSCOPY

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSITC SERVICES:MENTAL STATUS EXAM

8. DIAGNOSTIC SERVICES THIS VISIT: MENTAL STATUS EXAM

Taken from: National Ambulatory Medical Care Survey, 1981.

DIAGNOSTIC SERVICES:OTHER

8. DIAGNOSTIC SERVICES THIS VISIT: OTHER

Taken from: National Ambulatory Medical Care Survey, 1981.

FIRST DIAGNOSIS ASSOCIATED WITH ITEM 6A

9. PHYSICIAN'S PRINCIPAL DIAGNOSIS:FIRST DIAGNOSIS ASSOCIATED WITH ITEM 6A

Taken from: National Ambulatory Medical Care Survey, 1981.

SECOND DIAGNOSIS ASSOCIATED WITH ITEM 6A

9. PHYSICIAN'S PRINCIPAL DIAGNOSIS:SECOND DIAGNOSIS ASSOCIATED WITH ITEM 6A

Taken from: National Ambulatory Medical Care Survey, 1981.

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