Get Arkansas Dept Health
Arkansas Department of Health Communicable Disease Reporting Form Fax reports to 501 661-2428 4815 West Markham Street Slot 32 Little Rock AR 72205 Reporting facility name Facility city Reporter name Reporter phone - Physician name Physician phone - Disease Patient name Date of birth // Address Phone - City Zip County Gender Male Female Race American Indian/Alaskan Asian Black Ethnicity Hispanic Not Hispanic Hawaiian/Pac Islander White ....
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