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Plague case investigation report
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May 2016
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Description:cdc:25617
OMB No. 0920-0728
Public reporting burden of this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30329-4027; ATTN: PRA (0920-0728)
CDC 56.37 (E), Revised May 2016, CDC Adobe Acrobat 10.1, S508 Electronic Version, May 2016
PlagueCaseReportForm.pdf
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Content Notes:Case ID# -- Patient History -- Course of Current Illness -- Laboratory Evidence of Infection -- Plague Case Status -- Epidemiologic Investigation.
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