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Get NJ CDS-14 2017-2024
N Indian or Alaskan Native Ethnicity: Hispanic Non-Hispanic CLINICAL INFORMATION Yes , date: / / No (Definition of diagnosis for NJDOH surveillance purposes may include clinical findings, laboratory results, or diagnosis of exclusion) / / Symptom Onset Date: Has the clinician diagnosed this patient with Lyme disease? If exact onset date is unknown, did symptoms develop greater than 30 days before specimen collection? Yes No Onset Date Provided SIGNS OR SYMPT.
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