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Page 1 of 5CASE REPORT FORMTuberculosisTuberculosisEpiSurv No. Disease Name
Tuberculosis disease new caseTuberculosis disease relapse or reactivationLatent tuberculosis infection
(patient consent
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How to fill out case report form tuberculosis
How to fill out case report form tuberculosis
01
Obtain the case report form for tuberculosis from the appropriate healthcare facility or organization.
02
Fill out all necessary patient information, including name, age, sex, and contact information.
03
Record the date of diagnosis, initial symptoms, and relevant medical history.
04
Document the results of any tests or diagnostic procedures used to confirm the presence of tuberculosis.
05
Provide details of the treatment plan, including medications prescribed and any follow-up appointments scheduled.
06
Sign and date the form to confirm its accuracy and completeness before submitting it to the designated authorities.
Who needs case report form tuberculosis?
01
Healthcare providers treating patients with tuberculosis
02
Public health officials monitoring the spread of tuberculosis in a community
03
Research institutions studying the epidemiology and treatment of tuberculosis
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What is case report form tuberculosis?
Case report form tuberculosis is a document used to collect information about individuals diagnosed with tuberculosis.
Who is required to file case report form tuberculosis?
Healthcare providers and facilities are required to file case report form tuberculosis for every patient diagnosed with tuberculosis.
How to fill out case report form tuberculosis?
Case report form tuberculosis can be filled out by healthcare providers using the required information about the patient's diagnosis.
What is the purpose of case report form tuberculosis?
The purpose of case report form tuberculosis is to track and monitor cases of tuberculosis for public health purposes.
What information must be reported on case report form tuberculosis?
Information such as patient demographics, symptoms, diagnostic test results, and treatment plan must be reported on case report form tuberculosis.
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