Formulaire

Notifiable disease - Diphtheria (Form 12198*03)

Cerfa 12198*03

Diphtheria must be reported by health professionals (doctor or biologist) by any appropriate means (telephone, fax...) to the doctor of the LRA before even confirmation by the CNR or sending this card.

    Fill out the form

    To whom shall I send this form ?

    J'ai réalisé une démarche administrative

    Je donne mon avis sur Services Publics +. L'administration concernée me répondra.

    Je donne mon avis

    Émetteur du formulaire administratif : Ministry of Health

    Verified 20 June 2018 - Directorate for Legal and Administrative Information (Prime Minister)