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Dengue case investigation report
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07/2009
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Description:Law 81 of 1912 establishes that dengue and dengue hemorrhagic fever are reportable diseases to the Puerto Rico Department of Health. The health provider will complete in print lettering every question of the Dengue Case Investigation Report and will accompany the serum sample with this form. Please verify that the date of onset of symptoms and the date the serum sample was obtained are included. Without this information the sample will not be processed. On the upper left corner of the form, write the date (day, month, year) in which the report was completed.
Form Approved OMB No. 0920
CDC 56.31 A REV. 06/2009 (Front)
CDC 56.31 A REV. 07/2009 (Back)
CS110856
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Pages in Document:4 unnumbered pages
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