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DEPARTMENT OF HEALTH & FAMILY SERVICES Division of Public Health DPH 4192 (Rev. 02/08) DAY CARE IMMUNIZATION RECORD STATE OF WISCONSIN SS. 252.04,Wis. Stats. COMPLETE AND RETURN TO DAY CARE CENTER.

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What is form dph 4192?

Form DPH 4192 is a document used to report certain information to the designated public health authority.

Who is required to file form dph 4192?

The individuals or entities specified by the public health authority are required to file form DPH 4192.

How to fill out form dph 4192?

To fill out form DPH 4192, you need to provide the required information as prompted in the form. Follow the instructions provided by the public health authority.

What is the purpose of form dph 4192?

The purpose of form DPH 4192 is to collect and compile relevant information for public health monitoring and response.

What information must be reported on form dph 4192?

The specific details and information required on form DPH 4192 may vary based on the guidelines provided by the public health authority.

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