Daily Surveillance Form

FORM 002

HPA/2015

Health Protection Agency

Male' Republic of Maldives

Daily Surveillance Report

Date:____/____/_____

Reporting Facility:

Atoll & Island

General

Vaccine Preventable Diseases (immediate reporting via telepone 3014496)

Admission/OPD

U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5 U5 A5

Total

All Daily Reports must be faxed (3014484) or reported via SIDAS to Communicable Disease Surveillance before 12:01Pm every day

This Form Must not be EDITED

For further information or inquiries, please contact:

Health Protection Agency, Ministry of Health, Roshanee Building, Sosun Magu, Male’.

Telephone: +960-3014 496, Hotline: +960-3014 333, Fax: +960-3014 484 email: hpa@health.gov.mv

Forms and case definition booklet are available on ,

Revised 21st Jan2015

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Parent category: Medical