Fillable TB Reading Form 132ABB?AC@>3*DEE#0%* 132ABB?AF:CC*G,H*

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TB Reading Form 132ABB?AC@>3*DEE#0%* 132ABB?AF:CC*G,H*

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Country of origin: US
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03/26/2013/uhs
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132ABB?AC@>3*DEE#0%*
132ABB?AF:CC*G,H*
TB Reading Form
* * * *
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!
A!Tuberculosis!skin!test!was!performed!on____________________________________!
! ! ! ! ! ! ! (I-%,'%*I&#"(*J,;%K!
!
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On__________________by_______________________.!The!TB!skin!test!was!read!!
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!
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!
On__________________!and!the!Result____________________________.!
! (L,(%)! !!!!!!!!! ! ! !!!!!!!N44*O*#P%P*0mm,!3mm,!5mm!etc)!
!
! ! ! ! ! ! !
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Reading!by:!________________________________!
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!
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Lot!#____________________!
Expiration!Date___________!
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TB Reading Form 132ABBAC@3*DEE0%* 132ABBAF:CC*G,H*

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Completed 15 March 2022

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