Central Nervous System: 
Others : 
Headache Delerium Seizures Lethargy 
Paralysis: Flaccid Spastic 
Muscle VVeakness Bulbar Involvement 
Meningismus Nuchal Rigidity 
Other 
Jaundice Myalgia Pleurodynia 
Myositis Conjunctivitis 
H emorrhagic Phenomena Hepatomegaly 
Associated Illness: 
Fatal 
TREATMENT 
Antibiotics 
Other 
SPECIMENS SUBMITTED FOR EXAMINATION: 
Origin: Human Animal Other 
Date of 
Collection 
Throat Washing 
Spinal Fluid 
Others 
Specimen 
Stool 
Specimen Local File No, Date of Collection 
Serum: Acute 
Convalescent 
Virus Isolate: Source Passage 
Tissue Culture 
Mouse 
Egg 
Other 
STORAGE OF SPECIMENS: Duration Method 
LOCAL LABORATORY RESULTS: 
Clinical diagnostic: WBC Differential 
CSF: Cell Count % Lymphocytes 
Others 
Liver Function Studies 
Bacteriological Studies; 
Pathological Examinations; 
Virus Isolation; Specimen Method 
Results 
Serology ; 
Method used; CF Neut. 111 
Test Antigen 
- . , 

Acute 
Coo valeucent 
- 
Other Pertinent Information; 
44 
* U i GOVeHNMCNT PRINTING OPMCC I960 0~S98'070 
