Patient Demographic Information
Patient ID
*
First Name
*
Last Name
*
Birth Date
*
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Gender
*
Please Select
Female
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Ambiguous
Other
Measurement
Measure Date/Time
-
Month
-
Day
Year
Date Picker Icon
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Hour
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Minutes
AM
PM
AM/PM Option
Frequency
*
bpm
Location
Please Select
17137000 Brachial Artery
69105007 Carotid Artery
86547008 Dorsalis Pedis Artery
22286001 External Carotid Artery
43899006 Popliteal Artery
181358001 Posterior Tibial Artery
45631007 Radial Artery
36765005 Subclavian Artery
181349008 Superficial Femoral Artery
15672000 Superficial Temporal Artery
181351007 Tibial Artery
Regularity
Please Select
61086009 Pulse Irregular
271636001 Pulse Regular
Rhythm
Please Select
195103000 Bigeminal Pulse
284470004 Premature Atrial Contraction
248650006 Heart Irregular
80313002 Palpitations
271638000 Pulse Regularly Irregular
248649006 Heart Regular
29036000 Trigeminal Pulse
42807005 Pulses Alternans
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