Encounter Date: |
Location: |
IMMUNIZATIONS(PROTECT YOUR CHILD) | ||||
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Vaccine | Sequence No | Dose/ Units | Date Given | Date of Next Visit |
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BCG-Scar checked |
Date checked |
Date BCG repeated |
VITAMIN A CAPSULES FROM 6 MONTHS | |||
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VITAMIN A CAPSULE: Given orally | Tick if Given | Date of next visit | |
At 6 months or at first contact thereafter | |||
Dose/Units | |||
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