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PO BOX 193, 169 Rails Road Anger, NC 27501 Phone: (919) 3312001 *Fax (919) 3312003 www.crrnc.com ROUTINE STAT REPORT WITH CALL PHONE #: Patient s Name : Date of Birth : Patients Day Time Telephone
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How to fill out patient s name date
How to fill out patient's name and date:
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Begin by writing the patient's full name in the designated space provided. Make sure to write the name accurately and legibly.
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Below the name, indicate the date on which the form is being filled out. Include the day, month, and year to ensure accuracy and proper documentation.
Who needs patient's name and date:
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Healthcare providers and medical professionals require the patient's name and date to identify the individual accurately and distinguish them from other patients.
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