Institution (source of the report)

Institution Name
Address
Telephone
Postal Code
Primary Contact
Secondary Contact

Patient

Health Insurance Number
Surname
Given Name
Middle Name
Sex
Date of Birth
Address
Telephone
Postal Code

Report (test results)

Report Number/Accession
Reporting Institution
Report Date
Patient
Patient Address at Dx
Telephone
Ordering Practitioner
Ordering Address
Telephone
Postal Code
Type of Test/Analysis
Specimen Description
Specimen Collection Date
Diagnosis (coded*)
Recommendations (coded*)
Diagnosing Pracitioner

Practitioner

Surname
Given Name
Middle Name
License or Reference Number
Address
Telephone
Postal Code

* Coded Results

Diagnostic and clinical information is coded to the Bethesda system of reporting cervical or vaginal diagnoses. The coding also includes HPV results of reflexive tests. Coded results permit the data to be computationally analyzed.