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PATIENT INFORMATION FOR PATIENTS UNDER 18 YEARS OF AGE Date Patients name Last First Middle Address Street City Zip Nickname Birthdate Social Security # School Sports/Hobbies Parent or guardian name
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How to fill out patient s name
01
Open the patient's registration form.
02
Locate the field for the patient's name.
03
Begin by typing the patient's first name.
04
If applicable, type the patient's middle name or initial.
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Next, enter the patient's last name.
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If the patient has any suffix or title, include it as well (e.g., Jr., Sr., Dr.).
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Ensure the spelling and formatting of the name are correct.
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Double-check for any mistakes or missing information.
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Save or submit the completed patient's name into the system.
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