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Patient Under investigation (PUB) Form: Coronavirus Disease (COVID-19) Shaka Khanum Memorial Cancer Hospital & Research Center Patient first name ___ Patient last name ___ Patient date of birth ___
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Individuals who are experiencing symptoms of COVID-19, have had recent travel to high-risk areas, or have been in close contact with confirmed or suspected cases of COVID-19 may need to fill out the covid-19-pui-formpdf.
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What is covid-19-pui-formpdf?
covid-19-pui-formpdf is a form used for reporting potential COVID-19 cases and exposures.
Who is required to file covid-19-pui-formpdf?
Healthcare facilities, employers, and individuals may be required to file covid-19-pui-formpdf.
How to fill out covid-19-pui-formpdf?
covid-19-pui-formpdf can typically be filled out electronically or by hand, following the instructions provided on the form.
What is the purpose of covid-19-pui-formpdf?
The purpose of covid-19-pui-formpdf is to track and report potential COVID-19 cases and exposures to help prevent the spread of the virus.
What information must be reported on covid-19-pui-formpdf?
Information such as the individual's name, contact information, symptoms, exposure history, and test results may need to be reported on covid-19-pui-formpdf.
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