4 Month Check-Up Doctors Note Template Page 3

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IMMUNIATIONS
Your child received the following:
Pediarix (DTaP, IPV, HBV)
Given/Not given
IPV
Given/Not given
HBV
Given/Not given
HIB
Given/Not given
RotaTeq
Given/Not given
Pneumococcal (PCV7)
Given/Not given
Other immunizations given today:
COMMENTS

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