2 Tesseneer Drive, Highland Heights, KY 41076-9167
Telephone: +859 781 8877   Fax: +859 781 9310
Email: support@ppdi.com
PPD
Home   Call Log   Specification Sheet  
Current User: Shelly Smith (ssmith01)    Last Login: 08:59 06-Dec-2007
Caller
Information		 Caller Name: Phone: Fax: Study Number: Site Number:
James Mills - Monitor 555-555-5678 555-555-2323 10001 101
Email: Phone Toll Free: Fax Toll Free: Protocol Number: Call Start Time/Date:
jamesmills@monitor.com 888-555-5678   12321 09:05 06-Dec-2007
= changes from completion of DDE, sample entry = recent change = all tests reported
P
 = pending test  
Resident Information
Screening ID:
100001 		Randomization ID:
123456		 Accession ID:
888888
Initials:
AAA 		DOB:
12-Nov-1973		 Gender:
Male
Site Information
Mailing Address:
1234 Main Street, New Hope, MN 55428-3623
Phone:
763-404-1443 		Fax:
763-553-9796		 Email:
abccompany@somewhere.com
Visit History
Visit 1
Samples Clinical History
DSR: 02-Nov-2007 Exp: 6 Fasting
  Rec'd: 4 Weight: 185 lbs
Visit 2
DSR: 14-Nov-2007
 
Visit 3
DSR: 21-Nov-2007
 
Visit 4
DSR:
 
Visit 5
 
 
Sample Type
Test
Reported
Time/Date
Urine
12:01 02-Nov-2007
NS
01-Nov-2007
Heam
12:01 02-Nov-2007
NS
01-Nov-2007
Hbalc
12:01 02-Nov-2007
NS
01-Nov-2007
Chemistry
12:01 02-Nov-2007
NS
01-Nov-2007
Lipid
P
NS
01-Nov-2007
Storage        
Test
Reported
Urine
Heam
Hbalc
Chemistry
Lipid
P
Storage  
Test
Reported
Urine
Heam
Hbalc
Chemistry
Lipid
P
Storage  
Test
Reported
Urine
P
Heam
P
Hbalc
P
Chemistry
P
Lipid
P
Storage  
 
Outstanding     
Queries (2)
Subject
Issue
Date
Status
100001
Missing DOB
04-Nov-2007
P
100001
No entry recorded for Gender field
15-Oct-2007
O
Outstanding
Subject
Queries (5)
Subject
Issue
Date
Status
Missing Initials
04-Nov-2007
P
100006
No entry recorded for Gender field
15-Oct-2007
O
100010
Randomization ID has an invalid character
13-Oct-2007
P
100015
Missing DOB
07-Oct-2007
O
100021
Missing Initials
21-Sept-2007
O
Outstanding
Site Queries (9)
 Site 102
 Site 103
 Site 104