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{| class="wikitable"
! Field Label !! Database column name!! Data Typetype
|-
| Current Rehabilitation Pillar||current_rehabilitation_pillar||Single Select-select
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| How Long Use Prosthesis||how_long_use_prosthesis||Single Select-select
|-
| Included in assistance program||included_in_assistance_program||Single Select-select
|-
| Last Use Prosthesis||last_use_prosthesis||Single Select-select
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| Medical aid needs comment||medical_aid_needs_comment||Text
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| PriorityTechnical aid needs comments||Single Selecttechnical_aid_needs_comment||Text
|-
| QuantityVictim Included In Assistance Program||Integer||Multi-select
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| StatusWhere Use Prosthesis||where_use_prosthesis||Single Select-select
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| Technical aid needs comments||Text|-| Victim Included In Assistance Program||Multiple Select|-| Where Why Not Use Prosthesis||Single Select|-| Why Not Use Prosthesiswhy_not_use_prosthesis||Single Select-select
|-
|}