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59TH MEDICAL WING CUSTODIAN OF MEDICAL RECORDS AFFIDAVIT Before me, the undersigned authority, personally appeared who being by me duly sworn, deposed as follows; My name is, I am over 21 years of
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Texas 59TH MDW WHMC AFFIANT Lackland AFB undersigned Supersedes SUBSCRIBED herein memorandum deposed duplicates NOTARY CUSTODIAN thereof thereafter duly provider Administrator AFFIDAVIT

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