Report Year
State File Number
Facility *
Recorded City *
Recorded County *
Recorded Region *
Recorded State
Patient Number *
Patient Age
Marital Status
Abortion Month
Abortion Day
Abortion Year
Residence City
Residence In/Out City Limits
Residence State
Residence Zip
Residence County
Residence Region
|
Race
Hispanic Origin
Education
Now Living
Now Dead
Previous Spontaneous (Born Dead)
Induced (Previous Abortions)
Terminated Procedure
Last Menses Month
Last Menses Day
Last Menses Year
Clinical Gestation
Method of Estimating Gestation *
BPD Measurement *
Fetus Viable *
Physician License Number *
Calculated Gestation
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Update Code * |