TITLE 77: PUBLIC HEALTH
CHAPTER XII: EXPERIMENTAL ORGAN TRANSPLANTATION PROCEDURES BOARD
SUBCHAPTER a: EXPERIMENTAL ORGAN TRANSPLANTATION PROGRAM
PART 2800 TRANSPLANTATION PROGRAM
SECTION 2800.APPENDIX C ADDENDUM II - FACILITY EXPERIENCE

 

Section 2800.APPENDIX C  Addendum II - Facility Experience

 

FACILITY:

 

 

 

TYPE OF TRANSPLANT:

 

 

 

PERIOD COVERED*:

 

 

 

PATIENT**

AGE

DISEASE

TRANSPLANT

DATE

RETRANSPLANT

STATUS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*All patients in most recent twelve-month period.

**If funded by Experimental Organ Transplantation Program, indicate patient's name; otherwise use identifier only.

 

(Source:  Added at 12 Ill. Reg. 15550, effective September 16, 1988)