| Document Date: 2014-08-26 11:03:34
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Company Starbucks / / Country Canada / / Facility diner/neighbourhood café / Clinic Phone No. / bar I / Clinic Address / Clinic Postal Code C. Onset / / / IndustryTerm frozen chicken products / food items / frozen fish products / ethnic food / food alerts / food bank / powder store-bought puréed baby food / food warehouse stores / food / / Organization Public Health Nurse Region Health Unit / / Person Costco / / / Position Farm worker / Governor / farmer / Laboratory worker / Animal worker / AM/PM / Health care worker / Physician / Child care worker / General / Veterinarian/Vet assistant / / Region Caribbean / / Technology type / URL http /
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For use by Manitoba Health Case ID: ________________ Salmonella Questionnaire - General Report date (YYYY/MM/DD): ______/____/____