|Classification / Identification:|
| ||Form Number:||014-4344-64E||Edition date: ||2022/08 |
| ||Title:||Influenza Vaccine Order Form for the Universal Influenza Immunization Program|
| ||Ministry:||Health|| || |
| ||Branch/ABC:||Public Health|| || |
| ||Program:||Public Health - Disease Control Service|| || |
| ||Purpose of Form:||Eligibility Criteria for Trivalent Inactivated Influenza Vaccine.|| || |
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