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Form 3 Wastage Upload Report
Ryan White HIV/AIDS Program Mpox Vaccine Distribution
Appendix C_Wastage_Upload_Template.xlsx
Wastage Upload Report
OMB: 0915-0395
OMB.report
HHS/HSA
OMB 0915-0395
ICR 202307-0915-004
IC 261185
Form 3 Wastage Upload Report
( )
Document [xlsx]
Download:
xlsx
|
pdf
Federal PIN
Wastage Date
Description
Contact First Name
Contact Last Name
Wastage Reason
Doses Wasted
Lot Number
Expiration Date
File Type
application/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified
0000-00-00
File Created
0000-00-00
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