Fillable mygreatlakes autopy form

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RGI/CGHR PROSPECTIVE STUDY SRS - VERBAL AUTOPSY FORM Form 10B: Child death (29 days to 14 years) SRS unit number Year : CONFIDENTIAL Unique form number 1st HYS 2nd HYS Identi cation code of the head Identi cation code of the deceased Identi cation code of mother of the deceased 2 20 Name of the head of the household Full name of deceased Name of mother of the deceased Details of respondent 1. Name of respondent 2....
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