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P.

O Box 75838
Kampala, Uganda
Plot 440, Balintuma, Mengo, Kampala
+256 393228009; +256 772 587094
Email: info@irc.co.ug
http://www.irc.co.ug
Transforming Lives through Research

FIELD TEAM TABLET MONITORING FORM


SERIAL NAME TABLET SIGNATURE CONTACTS
NO. ID

TEAM SUPERVISOR: NAME………………………………………...

SIGNATURE……………………………………..

IT OFFICER: NAME:………………………………………………
SIGNATURE:………………………………………..

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