Module B

Newborn Enrollment

Maternal history · demographics · study ID generation

Enrollments: 1,284

DL-NBS-042-001

Date & Time of Birth *

Please select date and time of birth.

Sex *

Please select sex.

Gestational Age (weeks) *

Enter gestational age between 22–44 weeks.

Birth Weight (grams) *

Enter weight between 500–6000g.

APGAR Score (1 min) *

Enter APGAR score 0–10.

APGAR Score (5 min) *

Enter APGAR score 0–10.

Mode of Delivery *

Please select mode of delivery.

Mother's Name / UHID *

Mother's name is required.

Mother's Age *

Enter age between 12–55.

Gravida *

Gravida is required.

Parity *

Parity is required.

Consanguinity *

Please select consanguinity status.

Maternal Comorbidities

Hold Ctrl/Cmd to select multiple.

Family History of Metabolic/Genetic Disorder *

Please select family history status.

Primary Contact Number *

Enter a valid 10-digit phone number.

Alternate Contact Number

Residential Address *

Address is required.

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