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DX MEDICAL CENTRESREGISTRATION FORM (Please Print)PATIENT INFORMATION Patients Last name:First:Middle:Birth Date (DD//MM/BY): Mr. Mrs. Sex: MF Street address:Marital status (circle one) Miss Ms. Single
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Dx Medical Centres are medical facilities that provide diagnostics services such as x-rays, ultrasounds, CT scans, etc.
Healthcare providers or medical professionals who own or operate Dx Medical Centres.
Fill out the required information accurately, including patient details, diagnostic procedures performed, and any relevant medical findings.
The purpose of Dx Medical Centres is to provide diagnostic services to aid in the treatment and management of medical conditions.
Patient information, diagnostic test results, physician observations, and any follow-up recommendations.
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