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Wisconsin Tuberculosis (TB) Record

Wallet Card for TB Skin Test Results

Image of the Wisconsin Tuberculosis Record Card, click image for a larger view.

(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.

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Last Revised: September 11, 2007

 

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Wisconsin Department of Health and Family Services
Protecting and promoting the health and safety of the people of Wisconsin