Study Intake Form
Persistence of Ebola Virus in Body Fluids of Ebola Virus Disease Survivors in Sierra Leone
Att1_IntakeForm.xlsx
Study Intake Form
OMB: 0920-1064
Document [xlsx]
Download: xlsx | pdf
| A1 Page 1 – Persistence of Ebola Virus in Body Fluids of Ebola Virus Disease Survivors |
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| Attachment 1 — Intake Form | ||||||||||
| Date | Study Site | Participant Name | Age | Sex | Chiefdom | Ebola Treatment Unit Case Investigation Form Number | Survivor Certificate Number | EVD Discharge Certificate Number | National Identification Card Number | Assigned Unique ID |
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| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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