Health Care Surveys Reporting - Downloaded Version 2.0.0-ballot See the Directory of published versions
| Page standards status: Informative |
status: Completed
vaccineCode: Influenza, injectable, quadrivalent
patient: Dominique369 Ledner144 Female, DoB: 1965-06-22 ( MRN: Alaska Driver's License#abc123 (use: usual, ))
occurrence: 2024-10-15
primarySource: true
location: Location General Hospital - Main Campus
manufacturer: Organization General Hospital
lotNumber: 123456A
expirationDate: 2025-06-30
site: Left upper arm structure
route: Intramuscular route
doseQuantity: 0.5 mL
| Actor |
| Practitioner Joseph P Nichols (official) |
isSubpotent: false
| DocumentType | PublicationDate | PresentationDate |
| VIS | 2024-08-01 | 2024-10-15 |