Survey Text

1991
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1991
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1. Transcribe from shot record

Immunization: DTP/DT (shot)

3rd Shot:
Months ____
Day ____
Year 19 ____

b. At what age(s) did -- receive (additional) -- vaccine(s)?

A DTP/DT shot (sometimes called a DPT shot, diptheria-tetanus-pertussis-shot, baby shot, or three-in-one shot)

3rd

Age ____
1[] Months
2[] Years