Medical Record, Standard Form 507, is prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1.
Patient identification: For typed or written entries, give the name (last, first, middle), grade, rank, rate and hospital or medical facility.
Register and ward: REGISTER NO. and WARD NO.
Sign and date: Sign and date the form.
Reverse side: Continue on the reverse side.
| Question | Answer |
|---|---|
| Form Name | Standard Form 507 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 12 |
| Avg. time to fill out | 2 min |
| Edition | REV. 7-91 |
| Other names | SF 507, SF507, Form 507, Standard Form 507 |
| Official source | Standard Form 507 (REV. 7-91) |
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