| Variables in Hospitalization form (Hos) | |||||||
| Question# | Question | Field name | Response nature | Response options | |||
| 1 | Participant ID | hos_A | ### | ||||
| 2 | Initials of the mother | hos _B | XX | ||||
| 3 | Study researcher ID | hos _C | ## | ||||
| 4 | Today’s
date (According to English calender) |
hos _D | ##-XXX-## | dd-mmm-yy (99/999/99 if not known) | |||
| 5 | Date
of admission (According to English calender) |
hos _1 | ##-XXX-## | dd-mmm-yy (99/999/99 if not known) | |||
| 6 | Name of hospital where admitted | hos _2 | # | 1=Study site, 2= Bhaktapur H 3=Maternity H., 4=Patan H., 5= T. U. Teaching H., 6= Dhulikhel H., 7= KMC H., 8=Others | |||
| 9 | If other specify | hos _2 txt | TXT | TEXT
if hos_2=8 NA if hos_2ǂ8 |
|||
| 10 | Date
of discharge (According to English calender) |
hos _3 | ##-XXX-## | dd-mmm-yy (99/999/99 if not known) | |||
| 11 | Diagnosis/reason for hospitalization | hos _4 | TXT | TEXT | |||
| 12 | Management / Medications | hos _5 | TXT | TEXT | |||
| 13 | Is hospitalization possibly study related? | hos_6 | # | 1= Yes, 2=No, 3=Unknown | |||
| 14 | If yes, specify | hos_6 txt | TXT | NA
if hos_6=2 TEXT if hos_6ǂ2 |
|||
| 15 | Remarks | TXT | |||||