Case Reporting Form (CRF)
Back to ListDemography
Trial ID: T-001
Initials: JD
Gender: Female
Age: 45
Date of Entry: 07/12/2025
Habit Details
| Habit Name | Status | From Age | To Age | Frequency/Day |
|---|---|---|---|---|
| Smoking | Stopped a year ago | 25 | 29 | 4 |
| Alcohol | Current regular User | 25 | 29 | 1 |
Clinical Course Details
Diagnosis & Staging
Site: Oral Cavity
Subsite: Tongue
TNM: T:T2 N:N0 M:M0
Dimensions: Max: 3 cm, Min: 2 cm
Biopsy Report: SCC
Treatment History
Prior Radiotherapy: Yes (60G in 30#)
Prior Chemotherapy: Yes (Cisplatin)
Treatment Plan: Surgery
Surgery & Hospital Course
Admission Date: 01/12/2025
Surgery Date: 02/12/2025
Primary Surgery: WLE
Neck Dissection: Level I, Level II, Level III, Level IV
Reconstruction: Local flap
Post-Op & Discharge
Course in Hospital: Uneventful
Tracheostomy: Yes
NG Tube: Yes
NG Tube Removal Date: 07/12/2025
Discharge Date: 08/12/2025