| Label | Type | Description | Mandatory |
| Updated On | CURAM_DATETIME | The date on which the last update was made to the evidence. | No |
| Effective Date of Change | CURAM_DATE | Date which the evidence becomes effective | No |
| Approval Requested | CURAM_INDICATOR | Approval Requested | No |
| Screen Diagnosis | EVD_MEDICAL_SCREENING_DIAGNOSIS | The diagnosis of the screening. Examples include Breast Cancer, Cervical cancer, Precancerous Conditions and TB. | No |
|
| Updated By |
| Label | Type | Description | Mandatory |
| Updated By | USER_NAME | | No |
|
|
|
| Medical Screening Details |
| Label | Type | Description | Mandatory |
| Household Member | FULL_NAME | Drop-down list containing household members and their social security numbers. If the household member does not have a social security number, no number is displayed. | No |
|
| Certification Details |
| Label | Type | Description | Mandatory |
| Certification Start Date | CURAM_DATE | The date on which certification begins. | No |
| Certification End Date | CURAM_DATE | The date on which certification ends. | No |
|
| Comments |
| Label | Type | Description | Mandatory |
| Comments | COMMENTS | | No |
|
