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Tetanus Surveillance Worksheet NAME (Last, First) Hospital Record No. Address (Street and No.) City County Reporting Physician/Nurse/Hospital/Clinic Zip Phone Address Phone DETACH HERE and transmit
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The tetanus surveillance worksheet is a form used to track and monitor cases of tetanus infection.
Healthcare providers and facilities are required to file tetanus surveillance worksheet.
The tetanus surveillance worksheet must be filled out with accurate and detailed information on tetanus cases.
The purpose of the tetanus surveillance worksheet is to aid in the prevention and control of tetanus infections by tracking cases.
Information on the individual affected, symptoms, treatment, and exposure to tetanus must be reported on the worksheet.
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