Patient Data Fields
Name Action Length Allowed Values
Visit Type Select a value from the dropdown
list
Not
Applicable
• Scheduled
• Unscheduled
• Follow Up
• Repeat
• Early Termination
• Unknown
• The type you configured in the
Clinical Trial settings
Dose Type Select a value from the dropdown
list
Not
Applicable
The type you configured in the
Clinical Trial settings
Alphanumeric
17
characters
• A to Z
• a to z
• 0 to 9
• All characters are supported.
Number
10
characters
Extra
optional
one special
character (+)
or (-) in the
beginning
• 0 to 9
Yes or No or Unknown
<Question
1>*
<Question
2>*
<Question
3>*
<Question
4>*
<Question
5>*
Enter the answer
Not
Applicable
• Yes
• No
• Unknown
5864335-001-1  MAC
â„¢
5 A4/MAC
â„¢
5 A5/MAC
â„¢
5 Lite 311