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Form Id:
FRM_TPT
ENGLISH
  
FRANÇAIS
  
PORTUGUÊS
  
ITALIANO
Indication for TPT:
PLHIV
Prison setting
Household contact
HCW and other Facility staff
Other clinical risk group
Subcounty Registration Number:
Subcounty Registration Date:
Interruption of TPT treatment
TPT Discontinuation Date:
Reason for discontinuation::
Treatment complete
Lost to followup
Died
Transferred out
Active TB Disease - ATB
Adverse drug reaction - ADR
Poor adherence - PA
Discontinued
Others
Note: This is just a preview: not all features are guaranteed
Crop