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Get Acute Gastroenteritis/Norovirus Case Report Worksheet

(Y/N) Symptoms Symptom onset date (mm/dd/yy) Sex (M/F) Age Patient (P) Staff (S) Unique ID (optional) Name Patients only: Room/Bed Case Location Patient/Staff Demographics   1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. If required, REDACT Name column prior to faxing; FAX to local/state health department upon completion CS# 216887-A .

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Keywords relevant to Acute Gastroenteritis/Norovirus Case Report Worksheet

  • Norovirus
  • Sstate
  • 216887-A
  • worksheet
  • Gastroenteritis
  • faxing
  • Diagnostics
  • demographics
  • DEPT
  • cs
  • Stools
  • ONSET
  • optional
  • Completion
  • cramps
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