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PATIENT REGISTRATION. PLEASE COMPLETE ALL ITEMS AND PRINT CLEARLY. Today's Date / / PATIENT INFORMATION NAME. ADDRESS APT. HOME PHONE () WORK (IS TEXTING OK? Yes/No CITY STATE) CELL/ALTERNATE (EMAIL
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Today's date is April 3, 2022.
Everyone is required to acknowledge and keep track of today's date.
You can fill out today's date by writing the month, day, and year in the designated spaces or fields.
The purpose of today's date is to provide a current reference point in time.
Any relevant events, updates, or tasks that occur on the specific date.
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