| # | Question | Response |
|---|---|---|
|
1
|
Date Tablets Dispensed
field_001
|
|
|
2
|
Dispensed Treatment label ID
field_002
|
|
|
3
|
Number of Tablets Dispensed
field_003
|
|
|
4
|
Date Tablets Returned
field_004
|
|
|
5
|
Returned Treatment label ID
field_005
|
|
|
6
|
Number of Tablets Returned
field_006
|
|
|
7
|
Returned Amount Compliance
field_007
|
|
|
8
|
Reason Returned Amount Higher than Expected
field_008
|
|
|
9
|
Reason Returned Amount Lower than Expected
field_009
|