24-Nov-2014 21:17:01 [harish@127.0.0.1] {ADVERSE EVENT FORM} NEW entry #0 24-Nov-2014 21:17:01 [harish@127.0.0.1] {ADVERSE EVENT FORM} Email from to harish_jamin@yahoo.com,harish.amin@holiday.co.om, SMTP host smtp.omantel.net.om 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 220 fmgw1.omantel.net.om ESMTP Smtpd; Mon, 24 Nov 2014 21:15:09 +0400 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} EHLO localhost 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-fmgw1.omantel.net.om Hello [188.66.222.72], pleased to meet you 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-ENHANCEDSTATUSCODES 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-PIPELINING 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-8BITMIME 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-SIZE 32235520 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-DSN 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-AUTH LOGIN PLAIN 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-STARTTLS 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250-DELIVERBY 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250 HELP 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} AUTH LOGIN 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} Username 24-Nov-2014 21:17:02 [harish@127.0.0.1] {ADVERSE EVENT FORM} harish.amin@holiday.co.om 24-Nov-2014 21:17:03 [harish@127.0.0.1] {ADVERSE EVENT FORM} Password 24-Nov-2014 21:17:03 [harish@127.0.0.1] {ADVERSE EVENT FORM} **** 24-Nov-2014 21:17:03 [harish@127.0.0.1] {ADVERSE EVENT FORM} 235 2.0.0 OK Authenticated 24-Nov-2014 21:17:03 [harish@127.0.0.1] {ADVERSE EVENT FORM} MAIL FROM: 24-Nov-2014 21:17:03 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250 2.1.0 ... Sender ok 24-Nov-2014 21:17:03 [harish@127.0.0.1] {ADVERSE EVENT FORM} RCPT TO: 24-Nov-2014 21:17:04 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250 2.1.5 ... Recipient ok 24-Nov-2014 21:17:04 [harish@127.0.0.1] {ADVERSE EVENT FORM} RCPT TO: 24-Nov-2014 21:17:04 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250 2.1.5 ... Recipient ok 24-Nov-2014 21:17:04 [harish@127.0.0.1] {ADVERSE EVENT FORM} DATA 24-Nov-2014 21:17:04 [harish@127.0.0.1] {ADVERSE EVENT FORM} 354 Enter mail, end with "." on a line by itself 24-Nov-2014 21:17:04 [harish@127.0.0.1] {ADVERSE EVENT FORM} Date: Mon, 24 Nov 2014 21:17:01 +0400 To: harish_jamin@yahoo.com, "Harish" From: Harish User-Agent: Elog Version 2.9.2 MIME-Version: 1.0 Subject: New ELOG entry Message-ID: X-Elog-URL: http://localhost:8080/ADVERSE+EVENT+FORM/1 X-Elog-submit-type: web|elog Content-Type: text/html; charset="ISO-8859-1" Content-Transfer-Encoding: 7bit

A new entry has been submitted on localhost:

LogbookADVERSE EVENT FORM
SUBJECT INITIALS
SUBJECT ID
ADVERSE EVENT FORM-1
Adverse Event Description
Date of Onset
Time of Onset
Frequency of Episode
Was treatment given for AE
If Yes
any follow up visit required
Follow up date
Comments
ADVERSE EVENT FORM-2
Adverse Event Description
Date of Onset
Time of Onset
Frequency of Episode
Was treatment given for AE
If Yes
any follow up visit required
Follow up date
Comments
Logbook URLhttp://localhost:8080/ADVERSE+EVENT+FORM/1
. 24-Nov-2014 21:17:05 [harish@127.0.0.1] {ADVERSE EVENT FORM} 250 2.0.0 sAOHF99g021280-sAOHF99h021280 Message accepted for delivery 24-Nov-2014 21:17:05 [harish@127.0.0.1] {ADVERSE EVENT FORM} QUIT 24-Nov-2014 21:17:05 [harish@127.0.0.1] {ADVERSE EVENT FORM} 221 2.0.0 fmgw1.omantel.net.om closing connection 24-Nov-2014 21:17:53 [harish@127.0.0.1] {ENROLLMENT VISIT} NEW entry #0