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Get Morbidity Report Form

Los Angeles County Phone 213 745-0800 Fax 213 749-0926 Department of Public Health Confidential Morbidity Report of Tuberculosis Suspects Cases Rev 7/06 Under California law all TB suspects and cases must be reported within one working day Patient s Last Name First Middle Patient s Address City Date of Birth State / Age Zip Sex County Patient s SS Phone Occupation Country of Birth Date Arrived in U.S. White Black Asian spec. Ethnicity Hispanic.

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