Ka Wai Ola - Office of Hawaiian Affairs, Volume 5, Number 7, 1 Iulai 1988 — Page 13 Advertisements Column 1 [ADVERTISEMENT]
HAWAI'I BIOLOGICAL RESPONSE MODIFIERS RESEARCH LABORATORY JOHN A. BURNS SCHOOL OF MEDICINE, DEPARTMENT OF MEDICINE ST. FRANCIS HOSPITAL, SULLIVAN 477 2230 LILIHA ST„ HONOLULU, HAWAI'I 96817 TELEPHONE: (808) 595-2753 PLEASE PRINT Date NAME: First M\ddle Last HOME ADDRESS: HOME PHONE # Street Address WORK PHONE # City State Zip Code I AM % HAWAIIAN. SEX: M F DATE OF BIRTH mo/day/yr DO YOU OR ANY OF YOUR OHANA HAVE CANCER? YES NO IF YES: Please eheek. Number of cases: 1-2 3+ Type of cancer: Breast Colon Lung Other (specify):