Survey Text

2003
2002
2001
2000
1999
1998
1997
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2003
Survey form view entire document:  text  image
CIM.129

What is the name of the vaccine not listed on the shot record that I have NOT asked you about?
OTHEVO ----------------------------------

CIM.130

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a [Fill OTHEVO] shot?
OTH6
(1-6) 1-6 times
(7) Refused (CIM.140)
(9) Don't know (CIM.140)

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2002
Survey form view entire document:  text  image
CIM.129

What is the name of the vaccine not listed on the shot record that I have NOT asked you about?
OTHEVO ----------------------------------

CIM.130

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a [Fill OTHEVO] shot?
OTH6
(1-6) 1-6 times
(7) Refused (CIM.140)
(9) Don't know (CIM.140)

top
2001
Survey form view entire document:  text  image
CIM.129

What is the name of the vaccine not listed on the shot record that I have NOT asked you about?
OTHEVO ----------------------------------

CIM.130

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a [Fill OTHEVO] shot?
OTH6
(1-6) 1-6 times
(7) Refused (CIM.140)
(9) Don't know (CIM.140)

top
2000
Survey form view entire document:  text  image
CIM.129

What is the name of the vaccine not listed on the shot record that I have NOT asked you about?
OTHEVO ----------------------------------

CIM.130

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a [Fill OTHEVO] shot?
OTH6
(1-6) 1-6 times
(7) Refused (CIM.140)
(9) Don't know (CIM.140)

top
1999
Survey form view entire document:  text  image
CIM.129

What is the name of the vaccine not listed on the shot record that I have NOT asked you about?
OTHEVO ----------------------------------

CIM.130

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a [Fill OTHEVO] shot?
OTH6
(1-6) 1-6 times
(7) Refused (CIM.140)
(9) Don't know (CIM.140)

top
1998
Survey form view entire document:  text  image
CIM.129

What is the name of the vaccine not listed on the shot record that I have NOT asked you about?
OTHEVO ----------------------------------

CIM.130

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a [Fill OTHEVO] shot?
OTH6
(1-6) 1-6 times
(7) Refused (CIM.140)
(9) Don't know (CIM.140)

top
1997
Survey form view entire document:  text  image
CIM.129

What is the name of the vaccine not listed on the shot record that I have NOT asked you about?
OTHEVO ----------------------------------

CIM.130

FR: TRANSCRIBE FROM SHOT RECORD OR ASK:

Looking at the shot record, please tell me how many times {Child's name} has received a [Fill OTHEVO] shot?
OTH6
(1-6) 1-6 times
(7) Refused (CIM.140)
(9) Don't know (CIM.140)