Ill. Admin. Code tit. 77, pt. 2800, subpt. E, app C
Current through Register Vol. 49, No. 2, January 10, 2025
FACILITY: _____________________________________________________
TYPE OF TRANSPLANT: _________________________________________
PERIOD COVERED*: ____________________________________________
*All patients in most recent twelve-month period.
**If funded by Experimental Organ Transplantation Program, indicate patient's name; otherwise use identifier only.
Ill. Admin. Code tit. 77, pt. 2800, subpt. E, app C