Generated Narrative: QuestionnaireResponse questionnaire-response-01
| LinkID | Text | Definition |
Answer
|
|---|---|---|---|
 questionnaire-response-01 |
Questionnaire:http://ontariohealth.ca/legacy/Questionnaire/dr-garvey-chilopora-|0 | ||
questionnaire |
|||
section47163071 |
Patient Information | ||
item29578021 |
Height (cm): | 170 | |
|
item67890802 |
Weight (kg): | 80 | |
|
section2763158 |
Referral Information | ||
|
item48807357 |
Reason for Referral: | Some reason | |
|
section42000384 |
Pregnancy History | ||
|
item67762889 |
Total number of pregnancies: | 2 | |
|
item91252875 |
Number of vaginal deliveries: | 1 | |
|
item47328769 |
Number of C-sections: | 1 | |
|
item36834119 |
Number of miscarriages/pregnancy losses/ectopic pregnancies: | 3 | |
|
item29828101 |
Number of abortions/pregnancy terminations: | 2 | |
|
section41623208 |
Menstrual History | ||
|
item68062550 |
Date of Last Menstrual Period: | 2025-01-03 | |
|
item35661442 |
Number of days between periods: | 32 | |
|
item34464904 |
Number of days period lasts: | 8 | |
|
item12983596 |
Are patient's periods painful: | expandedYes-NoIndicator: Y (Yes) | |
|
item93188178 |
Are patient's periods heavy: | expandedYes-NoIndicator: Y (Yes) | |
|
item9542494 |
Number of pads/tampons used on the heaviest day of period: | 3 | |
|
section87236956 |
Gynecologic History | ||
|
section90671878 |
|||
|
item27527635 |
None | false | |
|
section95740632 |
|||
|
item97846576 |
Abnormal pap tests | true | |
|
item76524094 |
Fibroids | true | |
|
item62031353 |
Endometriosis | true | |
|
item78555427 |
Ovarian cysts | true | |
|
item86136829 |
Sexually transmitted infection(s) | true | |
|
item50977523 |
Specify: | ||
|
item127317 |
Date of last pap test: | 2026-02-28 | |
|
item54300787 |
Patient is sexually active: | expandedYes-NoIndicator: Y (Yes) | |
|
item96682694 |
With: | dr-garvey-chilopora-_item96682694: Both (Both) | |
|
item86913170 |
Form of birth control used: | ||
|
section4572141 |
Medical History | ||
|
section61677093 |
|||
|
item16667176 |
High blood pressure | true | |
|
item18948376 |
Diabetes | true | |
|
item35434575 |
Blood clots in lungs/legs | true | |
|
item69273958 |
Migraine headaches | true | |
|
item47066864 |
Liver disease/hepatitis | true | |
|
item75358255 |
Osteoporosis | true | |
|
item41631847 |
Infertility | true | |
|
item18292760 |
Cancer | true | |
|
item66877002 |
Type(s): | Unknown | |
|
item77134898 |
Thyroid problems | true | |
|
item880791 |
Asthma | true | |
|
item72238932 |
Anxiety/ Depression | true | |
|
item37884318 |
Incontinence (urine/stool) | true | |
|
item41904126 |
Constipation | true | |
|
item51470870 |
Frequent bladder infections | true | |
|
item15815594 |
Other | true | |
|
item78475900 |
Specify: | Stuff | |
|
i_nmedications_n |
Medications | ||
|
rx |
Aspirin | ||
|
allergies |
Allergies | ||
|
allg |
Cats | ||
|
i_npast_medical_histo |
Past Medical History | ||
|
pmhx |
None | ||
|
section68506771 |
Family History | ||
|
section48519309 |
|||
|
item65894204 |
High blood pressure | true | |
|
item82516489 |
Heart Disease/Stroke | true | |
|
item30885585 |
Diabetes | true | |
|
item4088333 |
Bad reaction to anesthetic | true | |
|
item37784990 |
Breast Cancer | true | |
|
item53504294 |
Uterine Cancer | true | |
|
item4801402 |
Ovarian Cancer | true | |
|
item75842905 |
Colon/Bowel Cancer | true | |
|
item22994219 |
Other Cancer(s) | true | |
|
item29254997 |
Specify: | Unknown | |
|
i_nsocial_history_n |
Social History | ||
|
section64573544 |
|||
|
item57834583 |
Smoker: | dr-garvey-chilopora-_item57834583: Yes (Yes) | |
|
item10529961 |
Number of years: | 3 | |
|
item44127211 |
Number of cigarettes per day: | 20 | |
|
item151992 |
Consumes alcohol: | expandedYes-NoIndicator: Y (Yes) | |
|
item94627251 |
Number of drinks per week on average: | 2 | |
|
item93764222 |
Uses recreational and/or street drugs: | expandedYes-NoIndicator: Y (Yes) | |
|
item74607677 |
Specify: | unknown | |
|
item33664919 |
Consumes caffeine: | expandedYes-NoIndicator: Y (Yes) | |
|
item45718527 |
Number of cups of coffee/tea/cola per day: | 2 | |
|
Documentation for this format
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