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2003

Survey form view entire document: text image

CIM.263

How many additional pneumococcal vaccines has {Child's name} received?

FR: ENTER 96 IF "ALL" IS REPORTED.

PNEMNO

(01-04) 1-4 shots
(96) All
(97) Refused
(99) Don't know

Check item CIMCCI6: If age LE 7, go to CIM.283.

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2002

Survey form view entire document: text image

CIM.263

How many additional pneumococcal vaccines has {Child's name} received?

FR: ENTER 96 IF "ALL" IS REPORTED.

PNEMNO

(01-04) 1-4 shots
(96) All
(97) Refused
(99) Don't know

Check item CIMCCI6: If age LE 7, go to CIM.283.

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2001

Survey form view entire document: text image

CIM.263

How many additional pneumococcal vaccines has {Child's name} received?

FR: ENTER 96 IF "ALL" IS REPORTED.

PNEMNO

(01-04) 1-4 shots
(96) All
(97) Refused
(99) Don't know

Check item CIMCCI6: If age LE 7, go to CIM.283.

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2000

Survey form view entire document: text image

CIM.263

How many additional pneumococcal vaccines has {Child's name} received?

FR: ENTER 96 IF "ALL" IS REPORTED.

PNEMNO

(01-04) 1-4 shots
(96) All
(97) Refused
(99) Don't know

Check item CIMCCI6: If age LE 7, go to CIM.283.

Survey Text