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8 X 4 50
8 X 4 50
Indications for use Complete this form for any client receiving or requesting a tuberculin skin test such as contacts persons targeted for screening or walk Tuberculin Skin Test (Mantoux only; no tine tests). Must be completed within 12 months prior to the start of classes. Date given: ___/___/___.
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8 X 4 50This questionnaire must be administered to all child care providers, by a licensed health care professional, before coming into contact with children. PPD Skin Test Record Form Patient Information I hereby agree to have a PPD tuberculin skin test To my knowledge I have not previously had a positive skin
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