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New Patient Registration Form Please Print Today's Date: PATIENT INFORMATION Full Legal Name (First) (Middle) (Last) Name Normally Used (Nickname) Address Apt. No. City State Email Home Phone Work
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What is today's date?
Today's date is September 23, 2021.
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The purpose of today's date is to accurately record when an event or deadline occurred or will occur.
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On today's date, information such as appointments, meetings, deadlines, and milestones may need to be reported.
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