Wisconsin Tuberculosis (TB) Record
Wallet Card for TB Skin Test Results

(Click on picture above to see larger image)
Wallet Cards are available in English, Spanish, and Hmong.
To order the cards, click on the link below and fill out form DMT0025A.
http://dhfs.wisconsin.gov/forms/DMT/dmt0025a.doc
The publication numbers for the wallet cards are:
DPH 4756 Wisconsin
Tuberculosis Record (English version)
DPH 4756S Wisconsin Tuberculosis
Record (Spanish version)
DPH 4756H Wisconsin Tuberculosis
Record (Hmong version)
For questions about the cards, please contact the TB
Program at 608-266-9692 or send an email to Helen
Norgord.
Last Revised: September 11, 2007
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