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meps.ahrq.gov/data_stats/nhc/new-fac.pdf
September 30, 1997 - OMB # 0935-0099
DATE: 09/30/97
FACILITY ID:
INTERVIEWER NAME:
INTERVIEWER ID:
DATE OF INTERVIEW: _______/_______/_______
MONTH DAY YEAR
TIME INTERVIEW BEGAN: am/pm
Department of Health and Human Services
Public Health Service
Agency for Health Care Policy and Research
and
National Center for Health Statistics
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meps.ahrq.gov/data_stats/nhc/cnf-nffq.pdf
September 30, 1997 - OMB # 0935-0099
EXPIRES: 09/30/97
PSF ID #:
INTERVIEWER NAME:
INTERVIEWER ID:
DATE OF INTERVIEW: ________/______/_______
MONTH DAY YEAR
TIME INTERVIEW BEGAN: am/pm
Department of Health and Human Services
Public Health Service
Agency for Health Care Policy and Research
and
National Center for Health Statistics
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meps.ahrq.gov/data_stats/nhc/fac-lvl.pdf
September 30, 1997 - OMB # 0935-0099
DATE: 09/30/97
FACILITY ID:
INTERVIEWER NAME:
INTERVIEWER ID:
DATE OF INTERVIEW: _______/_______/_______
MONTH DAY YEAR
TIME INTERVIEW BEGAN: am/pm
Department of Health and Human Services
Public Health Service
Agency for Health Care Policy and Research
and
National Center for Health Statistics
…