<?xml version="1.0" encoding="UTF-8"?>

<form xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xd="http://schemas.microsoft.com/office/infopath/2003"
	xmlns:openmrs="http://tambo.cell-life.org:8180/OPENMRSDTHF//moduleServlet/formEntry/forms/schema/13-42" id="13"
	name="Events Sheet" version="0.9">
	<header>
		<enterer>7^Simon Kelly</enterer>
		<date_entered>2007-04-07T11:20:29+02:00</date_entered>
		<session>A87E6186FF98FD178692158F8FDC82AE</session>
		<uid>jas8HJos0ksnle90jsni</uid>
	</header>
	<patient>
		<patient.birthdate openmrs_attribute="birthdate" openmrs_table="patient">19811125</patient.birthdate>
		<patient.birthdate_estimated openmrs_attribute="birthdate_estimated" openmrs_table="patient"></patient.birthdate_estimated>
		<patient.family_name openmrs_attribute="family_name" openmrs_table="patient_name">Mongo</patient.family_name>
		<patient.given_name openmrs_attribute="given_name" openmrs_table="patient_name">E</patient.given_name>
		<patient.medical_record_number openmrs_attribute="identifier" openmrs_table="patient_identifier"></patient.medical_record_number>
		<patient.pawc_folder_no openmrs_attribute="identifier" openmrs_table="patient_identifier">
			EM1569
		</patient.pawc_folder_no>
		<patient.preferred_id openmrs_attribute="identifier" openmrs_table="patient_identifier">
			EM1569
		</patient.preferred_id>
		<patient.cipra_patient_id openmrs_attribute="identifier" openmrs_table="patient_identifier"></patient.cipra_patient_id>
		<patient.art_register_no openmrs_attribute="identifier" openmrs_table="patient_identifier"></patient.art_register_no>
		<patient.dthf_patient_id openmrs_attribute="identifier" openmrs_table="patient_identifier"></patient.dthf_patient_id>
		<patient.pawc_patient_id openmrs_attribute="identifier" openmrs_table="patient_identifier">
			1569
		</patient.pawc_patient_id>
		<patient.middle_name openmrs_attribute="middle_name" openmrs_table="patient_name"></patient.middle_name>
		<patient.patient_id openmrs_attribute="patient_id" openmrs_table="patient">12356</patient.patient_id>
		<patient.sex openmrs_attribute="gender" openmrs_table="patient">F</patient.sex>
		<patient.tribe openmrs_attribute="tribe" openmrs_table="patient">13^PAWC</patient.tribe>
		<patient_address.address1 openmrs_attribute="address1" openmrs_table="patient_address"></patient_address.address1>
		<patient_address.address2 openmrs_attribute="address2" openmrs_table="patient_address"></patient_address.address2>
	</patient>
	<encounter>
		<encounter.encounter_datetime openmrs_attribute="encounter_datetime" openmrs_table="encounter" />
		<encounter.location_id openmrs_attribute="location_id" openmrs_table="encounter" />
		<encounter.provider_id openmrs_attribute="provider_id" openmrs_table="encounter">7</encounter.provider_id>
	</encounter>
	<obs openmrs_concept="1238^MEDICAL RECORD OBSERVATIONS^99DCT" openmrs_datatype="ZZ">
		<home_language openmrs_concept="1377^HOME LANGUAGE^99DCT" openmrs_datatype="ST">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</home_language>
		<education multiple="0" openmrs_concept="1378^EDUCATION^99DCT" openmrs_datatype="CWE">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</education>
		<employed_outside_home openmrs_concept="5608^EMPLOYED OUTSIDE HOME^99DCT" openmrs_datatype="BIT">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value infopath_boolean_hack="1" xsi:nil="true" />
		</employed_outside_home>
		<last_negative_hiv_test openmrs_concept="1381^LAST NEGATIVE HIV TEST^99DCT" openmrs_datatype="DT">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</last_negative_hiv_test>
		<positive_hiv_test_date openmrs_concept="1354^POSITIVE HIV TEST DATE^99DCT" openmrs_datatype="DT">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</positive_hiv_test_date>
		<reason_for_hiv_test multiple="0" openmrs_concept="1379^REASON FOR HIV TEST^99DCT" openmrs_datatype="CWE">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</reason_for_hiv_test>
		<mode_of_transmission_of_hiv multiple="0" openmrs_concept="1355^MODE OF TRANSMISSION OF HIV^99DCT"
			openmrs_datatype="CWE">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</mode_of_transmission_of_hiv>
		<hiv_disclosure_to_anyone_specific multiple="1" openmrs_concept="5616^HIV DISCLOSURE TO ANYONE, SPECIFIC^99DCT"
			openmrs_datatype="CWE">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<commnunity openmrs_concept="1386^COMMNUNITY^99DCT">false</commnunity>
			<other_non-coded openmrs_concept="5622^OTHER NON-CODED^99DCT">false</other_non-coded>
			<partner_or_spouse openmrs_concept="5617^PARTNER OR SPOUSE^99DCT">false</partner_or_spouse>
			<other_family_member openmrs_concept="5620^OTHER FAMILY MEMBER^99DCT">false</other_family_member>
			<health_care_provider openmrs_concept="5619^HEALTH CARE PROVIDER^99DCT">false</health_care_provider>
			<employer openmrs_concept="1385^EMPLOYER^99DCT">false</employer>
			<other_household_member openmrs_concept="5621^OTHER HOUSEHOLD MEMBER^99DCT">false</other_household_member>
			<friend openmrs_concept="5618^FRIEND^99DCT">false</friend>
			<none openmrs_concept="1107^NONE^99DCT">false</none>
		</hiv_disclosure_to_anyone_specific>
		<height_cm openmrs_concept="5090^HEIGHT (CM)^99DCT" openmrs_datatype="NM">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</height_cm>
		<weight_kg openmrs_concept="5089^WEIGHT (KG)^99DCT" openmrs_datatype="NM">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</weight_kg>
		<current_who_hiv_stage multiple="0" openmrs_concept="5356^CURRENT WHO HIV STAGE^99DCT" openmrs_datatype="CWE">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<value xsi:nil="true" />
		</current_who_hiv_stage>
		<adult_who_condition_query multiple="1" openmrs_concept="6048^ADULT WHO CONDITION QUERY^99DCT"
			openmrs_datatype="CWE">
			<date xsi:nil="true" />
			<time xsi:nil="true" />
			<encephalopathy openmrs_concept="5345^ENCEPHALOPATHY^99DCT">false</encephalopathy>
			<wasting_syndrome openmrs_concept="823^WASTING SYNDROME^99DCT">false</wasting_syndrome>
			<cardiomyopathy openmrs_concept="5016^CARDIOMYOPATHY^99DCT">false</cardiomyopathy>
			<progressive_multifocal_leukoencephalopathy
				openmrs_concept="5046^PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY^99DCT">
				false
			</progressive_multifocal_leukoencephalopathy>
			<hiv_staging_-_persistent_generalized_lymphadenopathy
				openmrs_concept="5328^HIV STAGING - PERSISTENT GENERALIZED LYMPHADENOPATHY^99DCT">
				false
			</hiv_staging_-_persistent_generalized_lymphadenopathy>
			<periodontitis openmrs_concept="1441^PERIODONTITIS^99DCT">false</periodontitis>
			<angular_cheilitis openmrs_concept="1437^ANGULAR CHEILITIS^99DCT">false</angular_cheilitis>
			<toxoplasmosis_central_nervous_system openmrs_concept="990^TOXOPLASMOSIS, CENTRAL NERVOUS SYSTEM^99DCT">
				false
			</toxoplasmosis_central_nervous_system>
			<hiv_staging_-_weight_loss_greater_than_ten_percent
				openmrs_concept="5339^HIV STAGING - WEIGHT LOSS GREATER THAN TEN PERCENT^99DCT">
				false
			</hiv_staging_-_weight_loss_greater_than_ten_percent>
			<hiv_staging_-_cryptosporidiosis openmrs_concept="5034^HIV STAGING - CRYPTOSPORIDIOSIS^99DCT">
				false
			</hiv_staging_-_cryptosporidiosis>
			<diarrhea_chronic openmrs_concept="5018^DIARRHEA, CHRONIC^99DCT">false</diarrhea_chronic>
			<hiv_staging_-_mycobacterium_other openmrs_concept="5043^HIV STAGING - MYCOBACTERIUM, OTHER^99DCT">
				false
			</hiv_staging_-_mycobacterium_other>
			<hiv_staging_-_lymphoma openmrs_concept="5041^HIV STAGING - LYMPHOMA^99DCT">false</hiv_staging_-_lymphoma>
			<invasive_cervical_carcinoma openmrs_concept="1444^INVASIVE CERVICAL CARCINOMA^99DCT">
				false
			</invasive_cervical_carcinoma>
			<anemia openmrs_concept="3^ANEMIA^99DCT">false</anemia>
			<hiv_staging_-_salmonella_septicemia openmrs_concept="5354^HIV STAGING - SALMONELLA SEPTICEMIA^99DCT">
				false
			</hiv_staging_-_salmonella_septicemia>
			<papular_pruritic_eruption openmrs_concept="1249^PAPULAR PRURITIC ERUPTION^99DCT">
				false
			</papular_pruritic_eruption>
			<asymptomatic_hiv_infection openmrs_concept="5327^ASYMPTOMATIC HIV INFECTION^99DCT">
				false
			</asymptomatic_hiv_infection>
			<hiv_staging_-_recurrent_bacterial_pneumonia
				openmrs_concept="1215^HIV STAGING - RECURRENT BACTERIAL PNEUMONIA^99DCT">
				false
			</hiv_staging_-_recurrent_bacterial_pneumonia>
			<hiv_staging_-_cryptococcosis_extrapulmonary
				openmrs_concept="5033^HIV STAGING - CRYPTOCOCCOSIS, EXTRAPULMONARY^99DCT">
				false
			</hiv_staging_-_cryptococcosis_extrapulmonary>
			<recurrent_oral_ulceration openmrs_concept="1438^RECURRENT ORAL ULCERATION^99DCT">
				false
			</recurrent_oral_ulceration>
			<isosporiasis_chronic openmrs_concept="1443^ISOSPORIASIS, CHRONIC^99DCT">false</isosporiasis_chronic>
			<hiv_staging_-_serious_bacterial_infections
				openmrs_concept="5030^HIV STAGING - SERIOUS BACTERIAL INFECTIONS^99DCT">
				false
			</hiv_staging_-_serious_bacterial_infections>
			<hiv_staging_-_candidiasis_ororespiratory_tract
				openmrs_concept="5340^HIV STAGING  - CANDIDIASIS, ORORESPIRATORY TRACT^99DCT">
				false
			</hiv_staging_-_candidiasis_ororespiratory_tract>
			<oral_hairy_leukoplakia openmrs_concept="5337^ORAL HAIRY LEUKOPLAKIA^99DCT">false</oral_hairy_leukoplakia>
			<pneumocystic_carinii_pneumonia openmrs_concept="882^PNEUMOCYSTIC CARINII PNEUMONIA^99DCT">
				false
			</pneumocystic_carinii_pneumonia>
			<hiv_staging_-_mucocutaneous_herpes_simplex
				openmrs_concept="5344^HIV STAGING - MUCOCUTANEOUS HERPES SIMPLEX^99DCT">
				false
			</hiv_staging_-_mucocutaneous_herpes_simplex>
			<hiv_staging_-_disseminated_endemic_mycosis
				openmrs_concept="5350^HIV STAGING - DISSEMINATED ENDEMIC MYCOSIS^99DCT">
				false
			</hiv_staging_-_disseminated_endemic_mycosis>
			<gingivitis openmrs_concept="126^GINGIVITIS^99DCT">false</gingivitis>
			<hiv_staging_-_recurrent_upper_respiratory_infection
				openmrs_concept="5012^HIV STAGING - RECURRENT UPPER RESPIRATORY INFECTION^99DCT">
				false
			</hiv_staging_-_recurrent_upper_respiratory_infection>