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Baseline (Baseline/Contact Information Data Entry Tabs) Database Field Name Description/Data Entry Field Label Type/Width Patient_Id SSN Alt_Id Alt_Id_Type Name_Last Name_First Name_Middle Name_Maiden DateofBirth Race1 Race2 Race3 Race4 Race5 Race6 Ethnicity PlaceofBirth_City PlaceofBirth_State PlaceofBirth_Country Enroll_Loc Enroll_Date ChronicDisease_Number Chart_Number Comments Primary_Street Primary_City Primary_State Primary_Zip Primary_County Phone_Day Phone_Nite Sec_Street Sec_City Sec_State Sec_Zip PatientStatus DateofDeath I_User_Id I_User_Date I_Modify_Date I_Create_Date Patient_Id_Old Converted_Record Patient Identifier (auto generated) SS (Social Security) Number Alt (Alternate) ID (Alternate ID) Type Last Name First (Name) Middle (Name) Maiden (Name) Date of Birth Race 1 Race 2 Race 3 Race 4 Race 5 Race 6 Ethnicity POB (Place of Birth) City (Place of Birth) State (Postal Code) (Place of Birth) Country Enrollment Location Enrollment Date CD (Chronic Disease) # Chart # Comments about patient Primary address - street Primary address - city Primary address - state (postal code) Primary address - zip code Primary address - County Day telephone number Night telephone number Secondary address - street Secondary address - city Secondary address - state (postal code) Secondary address - zip code PatientStatus Date of Death Last user to update record Date last modified Date last modified (client) Date record was created Holds ID from prevision version of system Flag for converted records Character Character Character Character Character Character Character Character Date Character Character Character Character Character Character Character Character Character Character Character Date Character Character Memo Character Character Character Character Character Character Character Character Character Character Character Character Date Character Date Date Date Character Logical February 2003 Format Name/Specifications/Skip Patterns 15 11 15 15 20 15 15 20 see Appendix III - uses FIPS code, data entry site code and counter from TRACKER table system automatically adds dashes in database field, 999-99-9999 used if woman doesn't have social security number (not in TAB order) text to describe alternate id used (not in TAB order) 2 2 2 2 2 2 1 20 2 20 7 Race Race Race Race Race Race Ethnicity StateAbbrAbbr (can be found in cast.fmt) autofilled with "USA" if one of 50 states from Provider_Sites table, with Enrollment field set to yes 9 9 45 20 2 10 20 20 20 45 20 2 10 1 StateAbbrAbbr (can be found in cast.fmt) uses list of counties from county.fmt file (stored as text) include special characters if you wish include special characters if you wish StateAbbrAbbr (can be found in cast.fmt) PatientStatus complete only if Patient Status = deceased 10 30 1 CaST 3.01 (DOS) and earlier set to 1 (yes) for CaST 3.01 data Appendix II CaST 5.0 Field Descriptions/Formats/Skip Patterns MDE fields are in BOLD (and Red) - system/read-only/hidden fields are in Italics (and Blue) Page 1