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Department of Health Hospitals Third Party Liability TPL Notification of Newborn Children In accordance with ACT No. 269 of the 2004 Regular Sesssion of the Louisiana Legislature this document will serve as the required notification regarding the birth of the child named herein. Date Contact Person email address Hospital Name Telephone No Was the newborn delivered in your facility Yes No Facility Provider No Admission Date of Newborn Child Discharge Date Attending Provider Name Will the...
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