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TB Skin Test Form Post Graduate Medical Education University of 2010
Negative Results Negative Induration Positive 10 mm induration 10 mm induration Last known negative BCG Vaccination No Yes Date Previous treatment for TB No Yes CHEST X-RAY required if TB test is positive or previously positive positive TB skin test is 10 mm induration Chest X-Ray Date Result Normal or Abnormal Trainee Authorization I give my consent that the information on this form may be shared with university/hospital teaching and administrative staff in appropriate cases. Signature of...
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