Document - Historical information/data - Dangerous Disease in Eagantown, County of Dakota - 3/21/1936Health Officer's Record of Cases of Disease Dangerous to the
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This Record Must be Kept in the Office of the Local Health Officer and
Record
Number
REPORT RECEIVED PATIENTS FULL NAME, AND FOR A CHILD,
PARENTS INITIALS OR GUARDIAN'S
NAME ALSO
Month Day Year
AGE
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OCCUPATION
(Iv AT SCHOOL, GIVE DISTRICT NUMBER
ea NAME or SCHOOL)
NAME OF DISEASE
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