Custom Document - Insert Merge Fields:
DC section

 

FIELD NAMES

FIELD DEFINITIONS

WHERE TO FIND IN MIS PROFESSIONAL

AdditionalTribe1

The race of decedent on the case.

Death Certificate Screen

AdditionalTribe2

The race of decedent on the case.

Death Certificate Screen

AZ_Reservation_Type

The type of reservation of decedent on which he is living. (This applies only when the death state is Arizona.)

                                      

Death Certificate Screen

AZReservation

The decedent is living on a reservation or not. (This applies only when the death state is Arizona.)

Example: Yes      

Death Certificate Screen

CafeSsnUnknown

DC field to define if the SSN is Unknown or there's No Social Security number for the decedent on the case.

Example: Unknown

Death Certificate Screen
CitizenOfCountry

Country of Citizenship

Example: United States of America

Death Certificate

Screen

County

County of Decedent's address

Example: Hillsboro

Death Certificate Screen
DcAmendDate

Date Amended

Example: 12/10/2015

Death Certificate Screen
DcAmendDate_Formatted

Date amended Date and Time format

Example:12/10/15 2:00PM

Death Certificate Screen

DCPhysician_Address

The attending physician’s address.

Example: 100 Main Street

Death Certificate Screen

DCPhysician_Area_Code

The attending physician’s phone number area code.

Example: (603)

Death Certificate Screen

DCPhysician_City

The attending physician’s city.

Example: Manchester

Death Certificate Screen

DCPhysician_CSZ

The attending physician’s city, state and zip code.

Example: Manchester, NH 03012

Death Certificate Screen

DCPhysician_Different_Mail_Addr If any of the fields MailingStreetAddress /MailingCity /MailingState/MailingZip is populated this flag is set as 1. The value can be same as primary address. Death Certificate Screen

DCPhysician_First_Name

The attending physician’s first name.

Example: John

Death Certificate Screen

DCPhysician_FML

The attending physician’s first, middle and last name.

Example: John R. Watkins

Death Certificate Screen

DCPhysician_FullSuffixName

The attending physician’s fully suffixed name.

Example: John R. Watkins, Jr.

Death Certificate Screen

DCPhysician_Last_Name

The attending physician’s last name.

Example: John

Death Certificate Screen

DCPhysician_Mailing_Salutation

The attending physician’s mailing salutation

Example: Dr. Watkins

Death Certificate Screen

DCPhysician_MailingCity

Physician's Mailing City

Example: Batesville

Death Certificate Screen
DCPhysician_MailingState

Physician's Mailing State

Example: NH

Death Certificate Screen
DCPhysician_MailingStateDescr

Physician's Mailing State

Example: New Hampshire

Death Certificate Screen
DCPhysician_MailingStreetAddress

Physician's Mailing Address

Example: 123 Main St

Death Certificate Screen
DCPhysician_MailingZip

Physician's Mailing Zip

Example: 03101

Death Certificate Screen

DCPhysician_Middle_Name

The attending physician’s middle name.

Example: John

Death Certificate Screen

DCPhysician_Phone

The attending physician’s phone number.

Example: (603)883-5692

Death Certificate Screen

DCPhysician_Phone_Last_7

The attending physician’s phone number; last 7 only.

Example: 883-5692

Death Certificate Screen

DCPhysician_Primary_Prefix

The attending physician’s name Prefix.

Example: Mr.

Death Certificate Screen
DCPhysician_PrimaryFullAddress

The attending physician’s address.

Death Certificate Screen

DCPhysician_State

The attending physician’s state.

Example: NH

Death Certificate Screen

DCPhysician_State_Descr

The attending physician’s full state name.

Example: New Hampshire

Death Certificate Screen

DCPhysician_Suffix

The attending physician’s name suffix.

Example: Jr.

Death Certificate Screen

DCPhysician_Zip

The attending physician’s zip code.

Example: 03102

Death Certificate Screen
DeathLocation_Different_Mail_Addr If any of the fields MailingStreetAddress /MailingCity /MailingState/MailingZip is populated this flag is set as 1. The value can be same as primary address Death Certificate Screen
DeathLocation_MailingCity

The death location's mailing city.

Example: Batesville

Death Certificate Screen
DeathLocation_MailingState

The death location's mailing state.

Example: NH

Death Certificate Screen
DeathLocation_MailingState_Descr

The death location's mailing state.

Example: New Hampshire

Death Certificate Screen
DeathLocation_MailingStreetAddress

The death location's mailing street address.

Example: 123 Main Street

Death Certificate Screen
DeathLocation_Mailing_Zip

The death location's mailing street zip.

Example: 03045

Death Certificate Screen

DeathLocation_State_Descr

The death location state where decedent death takes place on the case.

Example: Arizona

Death Certificate Screen

DeathLocationCity

The death location city where decedent death takes place on the case.

Example: Manchester

Death Certificate Screen

DeathLocationCounty

The death location county where decedent death takes place on the case.

Example: Brown

Death Certificate Screen

DeathLocationName

The death location name where decedent death takes place on the case.

Example: Elliot Hospital

Death Certificate Screen

DeathLocationState

The death location state where decedent death takes place on the case.

Example: AZ

Death Certificate Screen

DeathLocationStreet

The death location street where decedent death takes place on the case.

Example: One Elliot Way

Death Certificate Screen

DeathLocationZip

The death location zip where decedent death takes place on the case.

Example: 03103

Death Certificate Screen

DecedentCollegeEducation

The decedent’s college education level.

Example: 1

Death Certificate Screen

DecedentEducation

The decedent’s education level.

Example: 16

Death Certificate Screen
DecedentHispanic

Is Deceased Hispanic

Example:

Death Certificate Screen

EducationCd

The decedent’s education code. This is a behind-the-scenes field that uniquely identifies the different codes.

Example: 16

Death Certificate Screen

Embalmer_Name

Name of the Embalmer.

Death Certificate Screen
Embalmer_Different_Mail_Addr If any of the fields MailingStreetAddress /MailingCity /MailingState/MailingZip is populated this flag is set as 1. The value can be same as primary address Death Certificate Screen
Embalmer_MailingCity

The embalmer's mailing city.

Example: Batesville

Death Certificate Screen
Embalmer_MailingState

The embalmer's mailing state.

Example: NH

Death Certificate Screen
Embalmer_MailingStateDescr

The embalmer's mailing state.

Example: New Hampshire

Death Certificate Screen
Embalmer_MailingStreetAddress

The embalmer's mailing street address.

Example: 100 Elm St.

Death Certificate Screen
Embalmer_Mailing_Zip

The embalmer's mailing zip.

Example: 03045

Death Certificate Screen

HowLongInArizona

The time of decedent lives in Arizona. (This applies only when the death state is Arizona.)

Example: 4

Death Certificate Screen

HowLongInArizonaType

From how many days/months decedent lives in Arizona. (This applies only when the death state is Arizona.)

Example: Days     

Death Certificate Screen

Immediate_Cause

The Cause of Death of deceased.

 

Death Certificate Screen
InformantCallDate

Informant Call Date

Example: 2/1/2016

Death Certificate Screen
InformantCallDate_Formatted

Informant Call date and time

Example: 2/1/2016 12:00PM

Death Certificate Screen
IsDcSignedByMe

Was the DC signed by a Medical Examiner

Example: Yes

Death Certificate Screen
IsDecedentSmoke

Was the decedent a smoker

Example: No

Death Certificate Screen
IsGraveLocationUnknown

Is Grave Unknown?

Example: No

Death Certificate Screen
IsMeApproved

Is Medical Examiner on DC approved

Example: Yes

Death Certificate Screen
IsOfHispanicOrigin

Is Decedent of Hispanic origin

Example: Yes

Death Certificate Screen

IsPlaceOfDeathInCityLimits

It tells us whether place of death was in city limits or not.

Example: Yes

Death Certificate Screen
IsResidenceInCityLimits

Is Decedent Residence within City Limits?

Example: Yes

Death Certificate Screen
MaritalStatus   Death Certificate Screen

NativeAmericanTribe

The race of the decedent on the case

Death Certificate Screen

OriginOfDescent

The origin of the decedent on the case.

Example: American

Death Certificate Screen

OtherHispanic

The Hispanic Type of the decedent.

Death Certificate Screen

Place

The death location place of the decedent on the case.

Example: Manchester, Arizona

Death Certificate Screen

PlaceOfDeathType

The place of death type for the decedent on the case.

Example: Emergency Room

Death Certificate Screen
PlaceOfDeathTypeCd

This is a behind-the-scenes field that uniquely identifies the place of death codes.

Example: O

N/A

PlaceOfDeathTypeOther

The place of death type of decedent on the case.

Example: Other Place of Death Type

Death Certificate Screen

PrimaryTribe

The race of decedent on the case.

Death Certificate Screen

RaceOther

The race of the decedent on the case

Death Certificate Screen

SecondaryTribe

The race of decedent on the case.

Death Certificate Screen
TimeOfDeath

Time of Death of the decedent on the case

Example 2:00PM

Death Certificate Screen
TimeOfDeathMilitaryFormat

Time of Death, in Military format, of the decedent on the case.

Example 14:00

Death Certificate Screen

ToeTagNumber

The number on the toe-tag of the decedent.

Example: Tag10101

Death Certificate Screen

YearsAtResidence

The number of years at residence of the decedent on the case.

Example: 15

Death Certificate Screen