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National Tuberculosis Programme TB 16 – Annexure XVII

Year:…………….. Health Institution:………………………….


REGISTER OF TB SUSPECTS

DATE PATIENT
TB
REFERED FOR
DATE SUSPECT NAME IN FULL SEX AGE COMPLETE ADDRESS DATE RESULTS OF DIAGNOSIS REMRAKS
SPUTUM
NO. RESULTS EXAMINATION
EXAMINATION
RECEIVED
(M/ F) 1 2 3

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