[q]# place of occurrence
# usual residence of patient (mother)
# full maiden name of patient
# medical record number and social security number of patient
# Hispanic origin, if any, and race of patient
# age of patient
# education of patient
# sex of fetus
# patient married to father
# previous deliveries to patient
# single or plural delivery and order of plural delivery
# date of delivery
# date of last normal menses and physician's estimate of gestation
# weight of fetus in grams
# month of pregnancy care began (sic)
# number of prenatal visits
# when fetus died
# congenital malformations, if any
# events of labor and delivery
# medical history for this pregnancy
# other history for this pregnancy
# obstetric procedures and method of delivery
# autopsy
# medical certification f cause of spontaneous fetal death
# signature of attending physician or medical examiner including title, address and date signed
method of disposal of fetus
# signature and address of funeral director or hospital representative
# date received by registrar
# registrar's signature
# registration area and report numbers.[/q]
Cause she'll know all that.
