WMDA form: F90

Name F90
Description Request for Patient's Siblings Service

Dictionary Fields

Name of field on form Dictionary label (description) EMDIS fields (matching dictionary field) WMDA XML fields (matching dictionary field)
First line of address
(The first line of an address, generally for an organisation, can be any format)
ADDR_1
Second line of address
(The second line of an address, generally for an organisation, can be any format)
ADDR_2
Third line address
(The third line of an address, generally for an organisation, can be any format)
ADDR_3
City Address
(The city of an address, generally for an organisation, can be any format)
CITY
Country
(The country of an address, generally for an organisation, can be any format)
COUNTRY
Email
(email address, generally for an organisation, can be any format)
EMAIL
Fax Number
(Fax number, usually of an organisation)
FAX
Receiving institution
(Institution receiving a product ( sample, HPC))
INST_MARR_SENT
INST_SMP_SENT
Invoice institution
(institution responsible for paying, usually requesting TC or registry)
INST_PAY
Postal Code
(Post code of an organisation such as a registry or TC)
ZIP
Institution
(Identification of an institution, usually refers to a receiving or sending regsitry.)
INST_ID
Contact phone number
(The listed phone number to contact at an organisation usually a registry or transplant centre)
PHONE
First name
(Given name of an individual)
P_FNAME
Patient Identification
(Patient identification assigned by patient registry)
P_ID
RSV_PAT
Last name
(Surname of an individual)
P_LNAME
Date of birth
(Birth date)
CB_BIRTH_DATE
D_BIRTH_DATE
P_BIRTH_DATE
BIRTH_DATE