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No Yes Please Specify Age Skin Problem Diabetes Heart Disorder Meningitis Urinary Disorder Tuberculosis Epilepsy Fainting Spells Scoliosis ADD/ADHD Other Illness Describe Hospitalizations Serious Injuries Why /When Eye glasses or contact lens Eye or vision problems describe Hearing problem s or multiple ear infections No Yes Describe IMMUNIZATION RECORD Please complete schedule below. TYPE DATE Negative Anti TB-BCG Vacc. within 5 years OR The following Tests Mantoux Test within 1 year...
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What is medical form 17-18 18-19?
Medical form 17-18 18-19 is a form used to report medical expenses for the years 2017-2018 and 2018-2019.
Who is required to file medical form 17-18 18-19?
Individuals who incurred medical expenses during the years 2017-2018 and 2018-2019 are required to file medical form 17-18 18-19.
How to fill out medical form 17-18 18-19?
Medical form 17-18 18-19 can be filled out by providing details of medical expenses incurred during the specified years.
What is the purpose of medical form 17-18 18-19?
The purpose of medical form 17-18 18-19 is to report and document medical expenses for tax or reimbursement purposes.
What information must be reported on medical form 17-18 18-19?
Information such as the date of service, medical provider, type of service, and amount paid for medical expenses must be reported on medical form 17-18 18-19.
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