Survey Text

2003
2002
2001
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2003
Survey form view entire document:  text  image

CIM.286

How many additional Hepatitis A shots has {Child's name} received?

FR: ENTER 96 IF "ALL" IS REPORTED.
HEPAMNO
(01-04) 1-4 Shots (CIM.440)
(96)All (CIM.440)
(97) Refused (CIM.440)
(99) Don't know (CIM.440)

top
2002
Survey form view entire document:  text  image

CIM.286

How many additional Hepatitis A shots has {Child's name} received?

FR: ENTER 96 IF "ALL" IS REPORTED.
HEPAMNO
(01-04) 1-4 Shots (CIM.440)
(96)All (CIM.440)
(97) Refused (CIM.440)
(99) Don't know (CIM.440)

top
2001
Survey form view entire document:  text  image

CIM.286

How many additional Hepatitis A shots has {Child's name} received?

FR: ENTER 96 IF "ALL" IS REPORTED.
HEPAMNO
(01-04) 1-4 Shots (CIM.440)
(96)All (CIM.440)
(97) Refused (CIM.440)
(99) Don't know (CIM.440)