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NHAMCS-176 (1-12-2012) SAMPLE NATIONAL HOSPITAL AMBULATORY MEDICAL CARE SURVEY 2012 AMBULATORY SURGERY PATIENT RECORD Form Approved: OMB No. 0920-0278; Expiration date 12/31/2014 Assurance of confidentiality
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OMB number 3064 0072 refers to the Office of Management and Budget control number assigned to a specific information collection request.
The specific group or individuals required to file OMB number 3064 0072 depend on the nature and purpose of the information collection request. Please refer to the specific instructions or regulations associated with this OMB number for more details.
The instructions on how to fill out OMB number 3064 0072 can be found in the associated forms or guidance documents provided by the agency responsible for the information collection. It is recommended to carefully review and follow those instructions to ensure accurate and complete filing.
The purpose of OMB number 3064 0072 is specific to the information collection request it represents. The purpose may vary and can range from data gathering, regulatory compliance, research, or administrative processes. The specific purpose can be found in the associated forms or guidance documents provided by the agency.
The specific information that must be reported on OMB number 3064 0072 will be outlined in the associated forms or instructions. The required information may vary depending on the purpose and nature of the information collection. Please refer to the relevant documentation for specific reporting requirements.
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