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Get Hcp And Shigellosis Form

LHJ Use ID Reported to DOH Date // LHJ Classification Confirmed Probable By Lab Clinical Epi Link Shigellosis County REPORT SOURCE LHJ notification date // Investigation start date // Reporter check all that apply Hospital HCP Public health agency Other Outbreak-related LHJ Cluster LHJ Cluster Name DOH Outbreak Reporter name Reporter phone Primary HCP name OK to talk to case Yes No DK Primary HCP phone Date of interview // PATIENT INFORMATION Nam.

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