|Classification / Identification:|
| ||Form Number:||014-4455-64E||Edition date: ||2021/08 |
| ||Title:||Universal Influenza Immunization Program Pharmacy Form|
| ||Ministry:||Health|| || |
| ||Branch/ABC:||Public Health|| || |
| ||Program:||Public Health - Disease Control Service|| || |
| ||Purpose of Form:||Universal Influenza Immunization Program Pharmacy Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.|| || |
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