Part III. Identification

III.1

Registry Information

III.1.1

Abstractor

III.1.2

Suspense Flag

III.1.3

Year First Seen, Accession Number, and Sequence Number

III.1.4

Reporting Facility

III.1.6

ACoS Approved Flag

III.2

Patient Information

III.2.1

Name

III.2.1.1

Last Name

III.2.1.2

First Name

III.2.1.3

Middle Name

III.2.1.4

Maiden Name

III.2.1.5

Alias Last Name

III.2.1.6

Alias First Name

III.2.1.7

Religious Names

III.2.1.8

Name Suffix

III.2.1.9

Mother's First Name

III.2.2

Medical Record Number

III.2.3

Social Security Number

III.2.4

Phone Number (Patient)

III.2.5

Address at Diagnosis

III.2.5.1

Rules for Recording Address

III.2.5.2

Number and Street at DX

III.2.5.3

City at Dx

III.2.5.4

State at DX

III.2.5.5

ZIP at DX

III.2.5.6

County at DX

III.2.5.7

City at DX USPS

III.2.5.8

Country at DX

III.2.6

Marital Status

III.2.7

Sex

III.2.8

Religion

III.2.9

Race and Ethnicity

III.2.9.1

Codes For Race Field

III.2.9.2

Spanish/Hispanic Origin

III.2.10

Date of Birth

III.2.11

Age at Diagnosis

III.2.12

Birthplace

III.2.12.1

Birthplace - Country

III.2.12.2

Birthplace - State

III.2.13

Occupation and Industry

III.2.13.1

Occupation

III.2.13.2

Industry

III.2.13.3

Children

III.2.14

Patient No Research Contact Flag

III.2.15

Height

III.2.16

Weight

III.2.17

Tobacco Use

III.2.18

Source Comorbidity

III.3

Case Identification

III.3.1

Date of First Contact

III.3.1.1

Date of First Contact Flag

III.3.2

Dates of Inpatient Admission and Inpatient Discharge

III.3.2.1

Date of Inpatient Admission Flag

III.3.2.2

Date of Inpatient Discharge Flag

III.3.3

Date of Diagnosis

III.3.3.1

Coding Dates

III.3.3.2

Vague Dates

III.3.3.3

Approximation

III.3.3.4

Date of Diagnosis Flag

III.3.4

Place of Diagnosis

III.3.5

Class of Case

III.3.6

Type of Reporting Source

III.3.7

Type of Admission

III.3.8

Casefinding Source

III.3.9

Payment Source (Primary and Secondary) and Payment

III.3.10

Reporting Facility Referred From

III.3.11

Reporting Facility Referred To

III.3.12

Physicians

III.3.12.1

Phyaician License Numbers

III.3.12.2

Entering Physician NPI Codes

III.3.13

Comorbidity/Complications

III.3.14

ICD Revision Comorbidities and Complications

III.3.15

Discovered By Screening

III.3.16

Secondary Diagnosis 1 - 10