【法规名称】
【发文字号】 佳政办综[2010]6号
【颁布时间】 2010-03-12
【实施时间】 2010-03-12
【效力属性】 有效
【正 文】
第3页 佳木斯市2010年麻疹疫苗强化免疫活动实施方案
[接上页] 附件1: 麻疹疫苗强化免疫摸底与接种情况登记表 第 页共 页 乡(街、社区) 村(居委会) 学校 班级 登记时间: 登记员:接种员:
|
编号 |
家长姓名 |
儿童姓名 |
性别 |
出生日期 |
免疫史 |
是否流动 |
本次强化接种日期 |
备注 |
|
有 |
无 |
本地 |
流动 |
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| 备注:“ 免疫史”以接种证或卡的记录为准,有免疫史填“√”;无免疫史为“0”。本地、外地儿童在相应栏内填““√”。 附件2: 麻疹疫苗强化免疫接种统计表(本地儿童用) 市 县(区) 乡(镇、街道、社区) 村 填表人:日期年月 日
|
单位 |
应种儿童数 |
实种儿童数 |
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96 |
97 |
98 |
99 |
00 |
01 |
02 |
03 |
04 |
05 |
06 |
07 |
08 |
09 |
小计 |
96 |
97 |
98 |
99 |
00 |
01 |
02 |
03 |
04 |
05 |
06 |
07 |
08 |
09 |
小计 |
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合计 |
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| 备注:从表1统计汇总本表后,按出生年份逐级汇总上报至省。 附件3: 麻疹疫苗强化免疫接种统计表(流动儿童用) 市 县(区) 乡(镇、街道、社区) 村填表人:日期 年 月 日
|
单位 |
应种儿童数 |
实种儿童数 |
|
96 |
97 |
98 |
99 |
00 |
01 |
02 |
03 |
04 |
05 |
06 |
07 |
08 |
09 |
小计 |
96 |
97 |
98 |
99 |
00 |
01 |
02 |
03 |
04 |
05 |
06 |
07 |
08 |
09 |
小计 |
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合计 |
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| 注:从表1统计汇总本表后,按出生年份逐级汇总上报至省。
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