10- 144 C.M.R. ch. 253, § 3
Current through 2024-51, December 18, 2024
Data elements which may be requested or recorded include, but are not limited to the following:
Patient's Last Name (including Maiden name)
Patient's First Name and Middle Initial
Medical Record Number
Social Security Number
Birth Date
Street Address
Mailing Address (if different from above)
City or Town of Residence
County of Residence
State of Residence and Zip Code
Sex
Race
Attending Physician
Referring Physician
ICD codes
Hospital Code
Date of Diagnosis
Date of Discharge
Occupation/Industry
Place/Address of Work
10- 144 C.M.R. ch. 253, § 3