Obstetrics
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Resident: [text name="variable_22" default=""] OB Tracker: [text name="variable_23" default=""]

[text name="variable_1" default=""]yo G[text name="variable_2" default=""]P[text name="variable_3" default=""] with an EDD of [text name="variable_4" default=""] [select name="variable_5" value="by LMP c/w US|by US|w/o reliable dating"]
[select name="variable_10" value="A|B|O|AB"][select name="variable_11" value="+|-"] / Rub [select name="variable_15" value="IMM|NI|MISSING"] / GBS [select name="variable_29" value="unk|pos|neg"]

PROBLEMS:
[textarea name="variable_24" default="-"]

DATING US: [textarea name="variable_6" default=""]
ANATOMY US: [textarea name="variable_7" default=""]
OTHER: [textarea name="variable_8" default=""]

INTAKE LABS:
- Pap Smear: [text name="variable_9" default=""]
- Genetic Screen: [text name="variable_34" default=""]
- Ab Screen: [select name="variable_12" value="NEG|POS|MISSING"]
- RPR: [select name="variable_13" value="NEG|POS|MISSING"]
- HIV: [select name="variable_14" value="NEG|POS|MISSING"]
- HepBsAg: [select name="variable_16" value="NEG|POS|MISSING"]
- Hep C: [select name="variable_17" value="NEG|POS|MISSING"]
- Hemoglobin: [text name="variable_18" default=""]
- Urine Cx: [text name="variable_19" default=""]
- GC/CT: [text name="variable_20" default=""]
- Early GCT: [text name="variable_21" default=""]

SECOND & THIRD TRIMESTER
- 1HR GCT: [select name="variable_25" value="PASS|FAIL|MISSING|NOT TIME"]
- 3HR GTT: [select name="variable_26" value="N/A|PASS|FAIL|MISSING"]
- Hemoglobin: [text name="variable_27" default=""]
- RPR: [select name="variable_28" value="NEG|POS|MISSING"]
- Tdap: [text name="variable_32" default=""]
- Rhogam: [text name="variable_33" default=""]
- Presentation @ 36 wk: [select name="variable_30" value="not time|cephalic|breech|transverse|not performed"]
- Contraception: [text name="variable_31" default=""]
Resident: OB Tracker:

yo GP with an EDD of
/ Rub / GBS

PROBLEMS:


DATING US:
ANATOMY US:
OTHER:

INTAKE LABS:
- Pap Smear:
- Genetic Screen:
- Ab Screen:
- RPR:
- HIV:
- HepBsAg:
- Hep C:
- Hemoglobin:
- Urine Cx:
- GC/CT:
- Early GCT:

SECOND & THIRD TRIMESTER
- 1HR GCT:
- 3HR GTT:
- Hemoglobin:
- RPR:
- Tdap:
- Rhogam:
- Presentation @ 36 wk:
- Contraception:

Result - Copy and paste this output:

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