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Appendix 104Mumps Surveillance Worksheet NAME (last) (first)ADDRESS (Street and No.) Hospital Record No. This information will not be sent to REPORTING SOURCE TYPE NAME physician PH clinic ADDRESS

How to fill out mumps surveillance worksheet-appendix 10-4

How to fill out mumps surveillance worksheet-appendix 10-4

1. To fill out the mumps surveillance worksheet-appendix 10-4, follow these steps:
2. Begin by gathering all necessary information, such as patient demographics, symptoms, and laboratory test results.
3. In the first section of the worksheet, record the patient's personal details, such as their name, age, and contact information.
4. In the next section, document the date of symptom onset and any relevant symptoms experienced by the patient.
5. Proceed to fill out the vaccination history of the patient, including the dates and types of mumps vaccines received.
6. In the following section, record any additional laboratory tests conducted to confirm the diagnosis of mumps.
7. Finally, provide information on the treatment received by the patient, if applicable.
8. Double-check the completed worksheet for accuracy and completeness before submitting or storing it for future reference.

Who needs mumps surveillance worksheet-appendix 10-4?

1. The mumps surveillance worksheet-appendix 10-4 is needed by healthcare professionals, epidemiologists, and public health officials involved in monitoring and tracking cases of mumps.
2. It helps in compiling epidemiological data, monitoring trends, and facilitating communication between healthcare providers and public health authorities.

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What is mumps surveillance worksheet-appendix 10-4?

The mumps surveillance worksheet-appendix 10-4 is a form used to track and report cases of mumps in a specific population.

Who is required to file mumps surveillance worksheet-appendix 10-4?

Healthcare providers, public health agencies, and other relevant authorities are required to file the mumps surveillance worksheet-appendix 10-4.

How to fill out mumps surveillance worksheet-appendix 10-4?

The mumps surveillance worksheet-appendix 10-4 should be filled out by providing accurate and detailed information about each mumps case, following the instructions provided on the form.

What is the purpose of mumps surveillance worksheet-appendix 10-4?

The purpose of mumps surveillance worksheet-appendix 10-4 is to monitor and control the spread of mumps by documenting cases and tracking trends in a specific population.

What information must be reported on mumps surveillance worksheet-appendix 10-4?

Information such as the patient's demographics, symptoms, lab results, vaccination status, and any relevant exposure history must be reported on the mumps surveillance worksheet-appendix 10-4.

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