Survey Text

2003
2002
2001
2000
1999
1998
1997
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2003
Survey form view entire document:  text  image
CIM.030

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a DTP, DTaP, DT shot (Sometimes called a DPT shot, diphtheria tetanus-pertussis shot, baby shot, or three-in-one shot)?
DTP
(00) None (CIM.040)
(01-08) 1-8 shots
(97) Refused (CIM.040)
(99) Don't know (CIM.040)

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2002
Survey form view entire document:  text  image
CIM.030

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a DTP, DTaP, DT shot (Sometimes called a DPT shot, diphtheria tetanus-pertussis shot, baby shot, or three-in-one shot)?
DTP
(00) None (CIM.040)
(01-08) 1-8 shots
(97) Refused (CIM.040)
(99) Don't know (CIM.040)

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2001
Survey form view entire document:  text  image
CIM.030

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a DTP, DTaP, DT shot (Sometimes called a DPT shot, diphtheria tetanus-pertussis shot, baby shot, or three-in-one shot)?
DTP
(00) None (CIM.040)
(01-08) 1-8 shots
(97) Refused (CIM.040)
(99) Don't know (CIM.040)

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2000
Survey form view entire document:  text  image
CIM.030

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a DTP, DTaP, DT shot (Sometimes called a DPT shot, diphtheria tetanus-pertussis shot, baby shot, or three-in-one shot)?
DTP
(00) None (CIM.040)
(01-08) 1-8 shots
(97) Refused (CIM.040)
(99) Don't know (CIM.040)

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1999
Survey form view entire document:  text  image
CIM.030

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a DTP, DTaP, DT shot (Sometimes called a DPT shot, diphtheria tetanus-pertussis shot, baby shot, or three-in-one shot)?
DTP
(00) None (CIM.040)
(01-08) 1-8 shots
(97) Refused (CIM.040)
(99) Don't know (CIM.040)

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1998
Survey form view entire document:  text  image
CIM.030

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a DTP, DTaP, DT shot (Sometimes called a DPT shot, diphtheria tetanus-pertussis shot, baby shot, or three-in-one shot)?
DTP
(00) None (CIM.040)
(01-08) 1-8 shots
(97) Refused (CIM.040)
(99) Don't know (CIM.040)

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1997
Survey form view entire document:  text  image
CIM.030

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a DTP, DTaP, DT shot (Sometimes called a DPT shot, diphtheria tetanus-pertussis shot, baby shot, or three-in-one shot)?
DTP
(00) None (CIM.040)
(01-08) 1-8 shots
(97) Refused (CIM.040)
(99) Don't know (CIM.040)