Public Health Contagious Disease Report Form. Material: paper. Size: 3 1/2\" W. x 5 1/2\" L. Description: white cardstock; black printing on both sides; one side for stamp and addressee; reverse: doctor\'s form to report a contagious disease such as small pox, chicken pox, measles or diphtheria, to the Minnesota Department of Health, Division of Preventable Diseases, University Campus, Minneapolis, Minn.
