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Name
Visit Type
Dose Type
<Question
1>*
<Question
2>*
<Question
3>*
<Question
4>*
<Question
5>*
5864335-001-1
Action
Select a value from the dropdown
list
Select a value from the dropdown
list
Enter the answer
MAC
™
5 A4/MAC
Length
Allowed Values
Not
•
Scheduled
Applicable
•
Unscheduled
•
Follow Up
•
Repeat
•
Early Termination
•
Unknown
•
The type you configured in the
Clinical Trial settings
Not
The type you configured in the
Applicable
Clinical Trial settings
Alphanumeric
17
•
A to Z
characters
•
a to z
•
0 to 9
•
All characters are supported.
Number
10
•
0 to 9
characters
Extra
optional
one special
character (+)
or (-) in the
beginning
Yes or No or Unknown
Not
•
Yes
Applicable
•
No
•
Unknown
™
5 A5/MAC
™
5 Lite
Patient Data Fields
311
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