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Get Hepatitis A Report Format

DRAFT COPY U.S. DEPARTMENT OF HEALTH HUMAN SERVICES PUBLIC HEALTH SERVICE CDC VIRAL HEPATITIS CASE REPORT Centers for Disease Control and Prevention Hepatitis Branch G37 Atlanta Georgia 30333 The following questions should be asked for every case of viral hepatitis Prefix Mr. Mrs. Miss Ms. etc Last Preferred Name nickname First Middle Address Street City Phone - Zip Code -- SSN optional - - Only data from lower portion of form will be transmi.

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