Literal question
506)
(1) COPY DATES FROM THE CARD.
(2) WRITE '44'IN 'DAY' COLUMN IF CARD SHOWS THAT A DOSE WAS GIVEN, BUT NO DATE IS RECORDED.
(3) IF HEP-B IS GIVEN IN COMBINATION WITH DPT, RECORD SEPARATELY FOR BOTH DPT AND HEP-B.
506A)
DATE OF BIRTH
DAY _________
MONTH ________
YEAR ________
BBC
DAY _________
MONTH ________
YEAR ________
POLIO 0 (POLIO GIVEN AT BIRTH)
DAY _________
MONTH ________
YEAR ________
POLIO 1
DAY _________
MONTH ________
YEAR ________
POLIO 2
DAY _________
MONTH ________
YEAR ________
DPT 1
DAY _________
MONTH ________
YEAR ________
DPT 2
DAY _________
MONTH ________
YEAR ________
DPT 3
DAY _________
MONTH ________
YEAR ________
HEP. B1
DAY _________
MONTH ________
YEAR ________
HEP. B2
DAY _________
MONTH ________
YEAR ________
HEP. B3
DAY _________
MONTH ________
YEAR ________
MEASLES
DAY _________
MONTH ________
YEAR ________
VITAMIN A
DAY _________
MONTH ________
YEAR ________