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In the section ADDRESS, DATE, IV PATIENTS DIAGNOSIS To be, NOTE TO PHYSICIAN The person named, DATE OF EXAM, SEX, HEIGHT WEIGHT BLOOD PRESSURE, TUBERCULOSIS TB TEST a Date TB, and d Please Check if TB Test is enter the information the software demands you to do.
It is crucial to put down specific particulars inside the box e Results mm, f Action Taken if positive, g Chest Xray Results, h Please Check One of the Following, Active TB Disease Latent TB, LIC A CONFIDENTIAL, and PAGE OF.
The a Treatmentmedication type and, b Can patient manage own, If not what type of medical, SECONDARY DIAGNOSISES, a Treatmentmedication type and, and b Can patient manage own field enables you to point out the rights and responsibilities of all sides.
Fill out the form by checking the next sections: If not what type of medical, CHECK IF APPLICABLE TO OR ABOVE, between normal aging and dementia, Dementia The loss of intellectual, CONTAGIOUSINFECTIOUS DISEASE, a Treatmentmedication type and, and b Can patient manage own.
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