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Get Reporting Form For Cryptococcal Disease - Washington State ... - Doh Wa

(DOH) REPORT SOURCE LHJ notification date / / Investigation start date / / Lab Hospital HCP Reporter (check all that apply) Public health agency Other DOH Use ID Date Received / / DOH Classification Confirmed Probable No count; reason: Reporter name Reporter phone Primary HCP name Yes OK to talk to case? PATIENT INFORMATION No DK Date of interv.

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