| Document Date: 2013-07-29 10:50:41
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City City/Town / / Country Canada / / Facility restaurant R Spent / Motel R Group Home / Laboratory Information Specimen Collected R Throat / Patient Clinic / / IndustryTerm coffee shop/cafeteria/food / / MedicalCondition R Oophoritis / inflammation / mumps / R Orchitis / mumps disease / / Movie Next of Kin / / Organization Public Health Unit / Attended church / / Position Family Physician / / ProgrammingLanguage R / / ProvinceOrState No YYYY/MM/DD YYYY/MM/DD RUnknown RUnknown Province / /
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Appendix 3: Sample Mumps Outbreak Case Report and Follow-up Form