| A | B | C | D | E | F | |
|---|---|---|---|---|---|---|
1 | type | name | label | hint | appearance | |
2 | today | today | ||||
3 | ||||||
4 | begin group | group1 | 1 | |||
5 | text | facility_name | 1.1 Facility Name | w4 | ||
6 | integer | age | 1.2 Deceased Age | w1 | ||
7 | select_one age_units | age_unit | Select age unit | w1 horizontal-compact | ||
8 | select_one sex | sex | 1.3 Deceased Sex | w2 horizontal | ||
9 | end group | |||||
10 | ||||||
11 | begin group | group2 | 2 | |||
12 | date | date_injury | 2.1 Date of Injury | w2 | ||
13 | date | date_death | 2.2 Date of Death | w2 | ||
14 | end group | |||||
15 | ||||||
16 | begin group | group3 | 3 | |||
17 | select_one injury_place | injury_place | 3.1 Place of Injury Occurrence | w4 horizontal | ||
18 | select_one death_place | death_place | 3.2 Place of Death Occurrence | w2 | ||
19 | select_one mechanism | mechanism | 3.3 Mechanism of Injury | w2 | ||
20 | end group | |||||
21 | ||||||
22 | begin group | group4 | 4 | |||
23 | text | narrative | Incident Summary Narative | (From the autopsy report, police records, and bystander reports) Describe the cause of the injury. | multiline | |
24 | end group |