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Form Approved OMB No. 09200666 Exp. Date: 11/30/2019 www.cdc.gov/nhsn Pneumonia (PNE) Page 1 of 4 *required for saving **required for completion Facility ID: *Patient ID: Secondary ID: Patient Name,
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Start by writing the month, which is November (11).
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Next, write the day, which is the 30th (30).
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Lastly, write the year, which is 2019.
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