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PAID HEALTH DESCARTES COUNTY HEALTH DEPT. CC CASH RECEIPT FLU VACCINE YES CK # NO PLEASE PRINT CLEARLY Client Last Name: First Name: M/I: (Middle Initial) Male: Female: Date of Birth: Month Day Phone:
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What is receipt yes no flu?
Receipt Yes No Flu is a form that individuals may be required to fill out to report if they have received a flu vaccination.
Who is required to file receipt yes no flu?
Individuals who have received a flu vaccination may be required to file Receipt Yes No Flu.
How to fill out receipt yes no flu?
To fill out Receipt Yes No Flu, individuals need to indicate whether or not they have received a flu vaccination.
What is the purpose of receipt yes no flu?
The purpose of Receipt Yes No Flu is to track and monitor flu vaccinations among individuals.
What information must be reported on receipt yes no flu?
The only information required to be reported on Receipt Yes No Flu is whether an individual has received a flu vaccination.
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