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DEPARTMENT OF HEALTH SERVICES Division of Public Health F44771B (Rev 11/06)STATE OF WISCONSIN SS. 254.15, Wis. Stats Phone (608) 2665817 FAX (608) 2670402NURSING CASE CLOSURE REPORT Case Management
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It is a form used for reporting financial information.
Any individual or entity that meets the filing requirements.
The form must be completed accurately with all required financial information.
The purpose is to report financial information to the relevant authorities.
Details of financial transactions, income, expenses, and other relevant financial data.
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