34 MANUAL OF VACCINATION FOR THE
VACCINATION FORM No. 7.
Statement showing inspections made by the Assistant Superintendent of
Vaccination of—district for the—week of—
190 .
Date of |
Name of village |
Result of Inspection. |
Name of |
Conduct and work |
State of lymph and |
State of register. |
|||
Successful. |
Unsuccess- |
Absent. |
Total. |
||||||
Total ... |
This statement should be forwarded to the District Superintendent of Vaccination
immediately after the expiry of the week.
Date—
Signature of Assistant Superintendent of
Vaccination.