Index Case Name Age Sex Contact Generation Date of Birth (Mm/dd/yr)

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Index case Contact Name Age Date of Birth Sex

Generation (mm/dd/yr)
Relationship to CP Number CS Occupation Present Address Home Address
Index
Date of Exposure SX/SY Onset of Sx/ Sy Status of Quarantine Dates Outcome
to Index Isolation/Quarant
ine
Date of 1st Swab DRU RT-PCR Result Ct value Volume Date of 2nd Swab
(Gene target - (>500 uL)
Value)
DRU RT-PCR Result Ct value Volume
(Gene target - (>500 uL)
Value)

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